Healthcare Provider Details

I. General information

NPI: 1487575882
Provider Name (Legal Business Name): OUTER CAPE ABA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/22/2026
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 SALT HAY WAY
EASTHAM MA
02642-2652
US

IV. Provider business mailing address

25 SALT HAY WAY
EASTHAM MA
02642-2652
US

V. Phone/Fax

Practice location:
  • Phone: 860-575-4231
  • Fax:
Mailing address:
  • Phone: 860-575-4231
  • Fax:

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. ALEXANDRA NOEL AGRO
Title or Position: OWNER
Credential: BCBA/LABA
Phone: 860-575-4231