Provider Demographics
NPI:1174370381
Name:PATHFINDER BEHAVIOR SERVICES CORP
Entity type:Organization
Organization Name:PATHFINDER BEHAVIOR SERVICES CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/BCBA
Authorized Official - Prefix:
Authorized Official - First Name:SHEILA
Authorized Official - Middle Name:
Authorized Official - Last Name:FERNANDEZ BOUZA
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:813-400-9244
Mailing Address - Street 1:11265 RUNNING PINE DR
Mailing Address - Street 2:
Mailing Address - City:RIVERVIEW
Mailing Address - State:FL
Mailing Address - Zip Code:33569-2217
Mailing Address - Country:US
Mailing Address - Phone:813-400-9244
Mailing Address - Fax:
Practice Address - Street 1:2350 E STATE ROAD 60 STE 24
Practice Address - Street 2:
Practice Address - City:VALRICO
Practice Address - State:FL
Practice Address - Zip Code:33594-3705
Practice Address - Country:US
Practice Address - Phone:813-400-9244
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-06
Last Update Date:2024-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty