Healthcare Provider Details

I. General information

NPI: 1780201269
Provider Name (Legal Business Name): POSITIVE STEPS ABA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/30/2020
Last Update Date: 02/23/2022
Certification Date: 02/23/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1912 DAIRY RD
WEST MELBOURNE FL
32904-4046
US

IV. Provider business mailing address

200 ELDRON BLVD SE
PALM BAY FL
32909-3629
US

V. Phone/Fax

Practice location:
  • Phone: 321-413-3366
  • Fax: 321-306-2880
Mailing address:
  • Phone: 321-413-3366
  • Fax: 321-306-2880

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MISS YASAMIN IRENE SARPOOLAKI
Title or Position: OWNER
Credential: BCBA/ LBA
Phone: 321-413-3366