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Organization

BEHAVIOR PROFESSIONAL THERAPY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. JADY LAZO (PRESIDENT)
(305) 833-3939
Entity
Organization

Contact information

Practice address
220 CRYSTAL GROVE BLVD, LUTZ, FL 33548-6460
(813) 400-2401
(813) 489-4870
Mailing address
220 CRYSTAL GROVE BLVD, LUTZ, FL 33548-6460
(813) 400-2401
(813) 489-4870

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
251B00000X
Case Management Agency
251S00000X
Community/Behavioral Health Agency

Other

Enumeration date
07/25/2024
Last updated
09/13/2025
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