Healthcare Provider Details

I. General information

NPI: 1073093373
Provider Name (Legal Business Name): PINNACLE AUTISM SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/16/2018
Last Update Date: 08/16/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

908 JANICE DR
NEWARK DE
19713-4040
US

IV. Provider business mailing address

28 EDGEBROOKE WAY
NEWARK DE
19702-1642
US

V. Phone/Fax

Practice location:
  • Phone: 302-740-5726
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: TABITHA VETTORI
Title or Position: FOUNDER & CEO/CLINICAL DIRECTOR
Credential: BCBA
Phone: 302-740-5726