Basic Information
| Provider Information | |||||||||
| NPI: | 1851018683 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | BUTTERFLY EFFECTS, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 350 FAIRWAY DR STE 101 | ||||||||
| Address2: | |||||||||
| City: | DEERFIELD BEACH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 334411834 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8774182978 | ||||||||
| FaxNumber: | 8665002186 | ||||||||
| Practice Location | |||||||||
| Address1: | 225 CEDAR HILL ST STE 200 | ||||||||
| Address2: | |||||||||
| City: | MARLBOROUGH | ||||||||
| State: | MA | ||||||||
| PostalCode: | 017525900 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8888809270 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/24/2022 | ||||||||
| LastUpdateDate: | 10/24/2022 | ||||||||
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| AuthorizedOfficialLastName: | COLE | ||||||||
| AuthorizedOfficialFirstName: | LEAH | ||||||||
| AuthorizedOfficialMiddleName: | SHANICE | ||||||||
| AuthorizedOfficialTitleorPosition: | ABA TECHNICAN | ||||||||
| AuthorizedOfficialTelephone: | 4134270815 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MISS | ||||||||
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| NPICertificationDate: | 10/22/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 106S00000X | Y | 193200000X MULTI-SPECIALTY GROUP |
No ID Information.