Healthcare Provider Details

I. General information

NPI: 1679406797
Provider Name (Legal Business Name): NEUROBEHAVIOR LINK LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/08/2026
Last Update Date: 06/08/2026
Certification Date: 06/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7914 110TH AVE SE APT 606
NEWCASTLE WA
98056-1674
US

IV. Provider business mailing address

7914 110TH AVE SE APT 606
NEWCASTLE WA
98056-1674
US

V. Phone/Fax

Practice location:
  • Phone: 719-201-1321
  • Fax:
Mailing address:
  • Phone: 719-201-1321
  • 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: SIMONE MAZILU
Title or Position: CLINICAL DIRECTOR
Credential: BCBA
Phone: 719-201-1321