Healthcare Provider Details

I. General information

NPI: 1104758853
Provider Name (Legal Business Name): STARLIGHT ABA NV LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/29/2026
Last Update Date: 05/29/2026
Certification Date: 05/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 S VIRGINIA ST FL 8
RENO NV
89501-2403
US

IV. Provider business mailing address

320 ROEBLING ST # 815
BROOKLYN NY
11211-6651
US

V. Phone/Fax

Practice location:
  • Phone: 786-206-8768
  • Fax:
Mailing address:
  • Phone: 786-206-8768
  • 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: ABRAHAM TYBERG
Title or Position: DIRECTOR
Credential:
Phone: 603-350-4941