Healthcare Provider Details

I. General information

NPI: 1619466927
Provider Name (Legal Business Name): NEW BEGINNINGS ABA COMPANY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/02/2018
Last Update Date: 05/02/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

42 EDWARDS ST
SOUTHBRIDGE MA
01550-1937
US

IV. Provider business mailing address

42 EDWARDS ST
SOUTHBRIDGE MA
01550-1937
US

V. Phone/Fax

Practice location:
  • Phone: 774-318-1806
  • Fax: 508-471-5389
Mailing address:
  • Phone: 774-318-1806
  • Fax: 508-471-5389

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: MRS. LISA HAWKINS
Title or Position: OWNER
Credential:
Phone: 774-318-1806