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General NPI Number Information
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NPI Number | 1104636521
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Entity Type | Organization
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Legal Business Name | EARLY IMPACT ABA CORP.
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Dates
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Enumeration Date | 01/08/2025
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Last Update Date | 12/10/2025
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Provider Practice Location Address
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Address Line | 1215 MANATEE AVE W STE 107
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City | BRADENTON
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State | FL
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Zip | 34205-7517
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Country | US
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Telephone | 321-720-9226
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Fax | 813-212-2006
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Provider Business Mailing Address
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Address Line | 420 46TH ST NW
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City | BRADENTON
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State | FL
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Zip | 34209-1950
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Country | US
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Telephone | 321-720-9226
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Fax | 813-812-2006
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Authorized Official
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Title or Position | PRESIDENT
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Name | ANGELA ARTEAGA
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Credential | BCBA
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Telephone | 321-720-9226
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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