Organization · NPI-2

Behavior Professional Therapy

Behavior Analyst · Lutz, FL

NPI number1689402166
StatusActive
Last updated in NPPESSep 13, 2025

Details

NPI
1689402166
Entity type
Organization (NPI-2)
Legal business name
Behavior Professional Therapy
Organization subpart
No
Enumeration date
Jul 25, 2024
Certification date
Sep 13, 2025
Last updated
Sep 13, 2025

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
103K00000X Behavior Analyst––Yes
251B00000X Case Management––
251S00000X Community/Behavioral Health––

Practice location

220 Crystal Grove Blvd
Lutz, FL 33548-6460

Phone 813-400-2401 · Fax 813-489-4870

Mailing address

220 Crystal Grove Blvd
Lutz, FL 33548-6460

Phone 813-400-2401 · Fax 813-489-4870

Authorized official

Jady Lazo
President
3058333939

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