Healthcare Provider Details

I. General information

NPI: 1316552177
Provider Name (Legal Business Name): TREETOP THERAPY MA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/09/2020
Last Update Date: 12/16/2021
Certification Date: 12/16/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 CAMBRIDGE ST STE 1400
BOSTON MA
02114-2545
US

IV. Provider business mailing address

1 STATE STREET PLAZA 29TH FLOOR
NEW YORK NY
10004
US

V. Phone/Fax

Practice location:
  • Phone: 857-321-8922
  • 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 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: JUDAH SCHILLER
Title or Position: MANAGING PARTNER
Credential:
Phone: 857-321-8922