Healthcare Provider Details
I. General information
NPI: 1114884970
Provider Name (Legal Business Name): BEHAVIOR MOMENTUM SOLUTIONS INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/05/2026
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
16922 AIRPORT BLVD STE 1
MOJAVE CA
93501-1657
US
IV. Provider business mailing address
16922 AIRPORT BLVD STE 1
MOJAVE CA
93501-1657
US
V. Phone/Fax
- Phone: 818-430-2128
- Fax:
- Phone: 661-499-5045
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103K00000X |
| Taxonomy | Behavior Analyst |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MS.
MELODY
QIANA
WILLIS
Title or Position: OWNER/ CLINICAL DIRECTOR
Credential: BCBA
Phone: 818-430-2128