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General NPI Number Information
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NPI Number | 1114331071
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Entity Type | Organization
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Legal Business Name | THRIVE ABA CONSULTING LLC
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Dates
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Enumeration Date | 06/18/2014
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Last Update Date | 06/18/2014
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Provider Practice Location Address
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Address Line | 120 BOWERY ST #308
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City | VIRGINIA BEACH
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State | VA
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Zip | 23462-3756
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Country | US
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Telephone | 843-714-4266
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Fax |
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Provider Business Mailing Address
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Address Line | 120 BOWERY ST #308
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City | VIRGINIA BEACH
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State | VA
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Zip | 23462-3756
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. ZACK MIGIOIA
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Credential |
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Telephone | 843-714-4266
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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 | 0133000315
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License Number State | VA
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