Healthcare Provider Details
I. General information
NPI: 1245038173
Provider Name (Legal Business Name): YES ABA NM LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/05/2025
Last Update Date: 12/03/2025
Certification Date: 12/03/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
500 MARQUETTE AVE NW
ALBUQUERQUE NM
87102-5340
US
IV. Provider business mailing address
PO BOX 995
LAKEWOOD NJ
08701-0995
US
V. Phone/Fax
- Phone: 347-699-2092
- Fax:
- Phone: 347-699-2092
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103T00000X |
| Taxonomy | Psychologist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251S00000X |
| Taxonomy | Community/Behavioral Health Agency |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103K00000X |
| Taxonomy | Behavior Analyst |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MORDECHAI
SZANZER
Title or Position: MANAGER
Credential:
Phone: 347-699-2092