Healthcare Provider Details

I. General information

NPI: 1255995007
Provider Name (Legal Business Name): BEHAVIORAL HARMONY LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/26/2019
Last Update Date: 12/11/2019
Certification Date: 12/11/2019
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4310 AVONDALE LN NW
CANTON OH
44708-1670
US

IV. Provider business mailing address

4310 AVONDALE LN NW
CANTON OH
44708-1670
US

V. Phone/Fax

Practice location:
  • Phone: 330-685-3885
  • Fax: 330-319-8330
Mailing address:
  • Phone: 330-685-3885
  • Fax: 330-319-8330

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: VICTORIA WALKER
Title or Position: OWNER/CLINICAL DIRECTOR
Credential: MSPSY, BCBA, COBA
Phone: 330-685-3885