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Organization
METAMORPHOSIS THERAPY LLC
Active
Organization
METAMORPHOSIS THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRIDGETT ELAINE DIMANT SLP (OWNER)
(407) 285-7907
Entity
Organization
Contact information
Practice address
1450 DANIELS RD, WINTER GARDEN, FL 34787-4376
(407) 395-9976
Mailing address
13750 W COLONIAL DR STE 350-121, WINTER GARDEN, FL 34787-4204
(407) 395-9976
(407) 992-9368
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
—
106S00000X
Behavior Technician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
017434700
—
FL
Enumeration date
08/19/2016
Last updated
08/22/2023
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