Healthcare Provider Details

I. General information

NPI: 1649878802
Provider Name (Legal Business Name): PIVOTAL ABA THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/10/2020
Last Update Date: 05/29/2026
Certification Date: 05/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1742 GEORGETOWN RD STE A&B
HUDSON OH
44236-5006
US

IV. Provider business mailing address

10385 OVIATT LN
TWINSBURG OH
44087-1472
US

V. Phone/Fax

Practice location:
  • Phone: 330-603-8534
  • Fax:
Mailing address:
  • Phone: 330-603-8534
  • 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: JEANINE PATRICE SIGNS
Title or Position: OWNER AND EXECUTIVE DIRECTOR
Credential: BCBA
Phone: 330-603-8534