Healthcare Provider Details

I. General information

NPI: 1891175543
Provider Name (Legal Business Name): POSITIVE ABA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/08/2015
Last Update Date: 06/08/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18521 E QUEEN CREEK RD STE 105-627
QUEEN CREEK AZ
85142-5870
US

IV. Provider business mailing address

18521 E QUEEN CREEK RD, STE 105-627
QUEEN CREEK AZ
85142
US

V. Phone/Fax

Practice location:
  • Phone: 480-361-1025
  • Fax: 480-814-7488
Mailing address:
  • Phone: 480-361-1025
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name: MISS ERICA BABINO
Title or Position: CEO
Credential: M.ED., BCBA, LBA
Phone: 480-361-1025