MEDICARE: TREASURED HEARTS ABA LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1841888047
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TREASURED HEARTS ABA LLC

Provider Business Mailing Address
First Line	:	18025 GRAND PROSPERITY DR
Second Line	:
City	:	VENICE
State	:	FL
Zip	:	34293-4966
Country	:	US
Telephone Number	:	703-596-2237
Fax Number	:	540-744-1091

Provider Business Practice Location Address
First Line	:	1108 EDEN WAY N STE E
Second Line	:
City	:	CHESAPEAKE
State	:	VA
Zip	:	23320-3339
Country	:	US
Telephone Number	:	703-596-9332
Fax Number	:	540-744-1091

Authorized Official
Title or Position	:	CLINICAL DIRECTOR
Name	:	MRS. PAMELA LYN REZA
Credential	:	BCBA, LBA
Telephone Number	:	540-538-6618

Provider Enumeration Date	:	01/05/2021
Last Update Date	:	03/18/2026

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