Healthcare Provider Details

I. General information

NPI: 1861982522
Provider Name (Legal Business Name): ABA BRIDGE SOLUTIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/17/2018
Last Update Date: 06/09/2020
Certification Date: 06/09/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2905 S FEDERAL HWY STE C8
DELRAY BEACH FL
33483-3267
US

IV. Provider business mailing address

2905 S FEDERAL HWY STE C8
DELRAY BEACH FL
33483-3267
US

V. Phone/Fax

Practice location:
  • Phone: 239-776-2814
  • Fax: 954-206-0827
Mailing address:
  • Phone: 239-776-2814
  • Fax: 954-206-0827

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MRS. BRITTANY KRISTINE JOHNSON
Title or Position: OWNER
Credential: BCBA
Phone: 239-776-2814