Organization
BODHI TREE THERAPEUTIC SERVICES
Active
Organization
BODHI TREE THERAPEUTIC SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHAKIRA VASQUEZ MOSCOSO LMHC (OWNER)
(202) 374-0573
Entity
Organization
Contact information
Practice address
5512 FAIRFAX ST, ORLANDO, FL 32812-7732
(202) 374-0573
Mailing address
5512 FAIRFAX ST, ORLANDO, FL 32812-7732
(202) 374-0573
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MH17846
LICENSE
FL
Enumeration date
07/26/2022
Last updated
07/26/2022
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up