Healthcare Provider Details

I. General information

NPI: 1427842277
Provider Name (Legal Business Name): I & C ABA ASSOCIATES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/07/2025
Last Update Date: 04/07/2025
Certification Date: 04/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8 MILTON ST APT 2
LYNN MA
01902-1529
US

IV. Provider business mailing address

8 MILTON ST APT 2
LYNN MA
01902-1529
US

V. Phone/Fax

Practice location:
  • Phone: 805-722-4924
  • 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 Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name: VIRIDIANA LOERA
Title or Position: CO-FOUNDER
Credential:
Phone: 805-722-4924