Healthcare Provider Details

I. General information

NPI: 1730743808
Provider Name (Legal Business Name): TALK ABA, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/24/2019
Last Update Date: 04/24/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1752 E BULLARD #101
FRESNO CA
93710-5864
US

IV. Provider business mailing address

1752 E BULLARD #101
FRESNO CA
93710-5864
US

V. Phone/Fax

Practice location:
  • Phone: 559-970-8277
  • Fax: 559-549-6261
Mailing address:
  • Phone: 559-970-8277
  • Fax: 559-549-6261

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name: MRS. AMY M PRINCE
Title or Position: CO-OWNER
Credential: MA-CCC, SLP, NCNA
Phone: 559-288-7343