MEDICARE: DEVELOPMENTAL PATHWAYS, INC

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	:	1992419063
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DEVELOPMENTAL PATHWAYS, INC

Provider Business Mailing Address
First Line	:	7120 HAYVENHURST AVE STE 322
Second Line	:
City	:	VAN NUYS
State	:	CA
Zip	:	91406-3813
Country	:	US
Telephone Number	:	725-500-5552
Fax Number	:	800-930-7957

Provider Business Practice Location Address
First Line	:	3960 HOWARD HUGHES PKWY STE 500
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89169-5988
Country	:	US
Telephone Number	:	725-500-5552
Fax Number	:

Authorized Official
Title or Position	:	CLINICAL DIRECTOR/CEO
Name	:	ERICA ARIUS
Credential	:
Telephone Number	:	818-821-0083

Provider Enumeration Date	:	01/12/2023
Last Update Date	:	01/12/2023

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