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General NPI Number Information
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NPI Number | 1144813114
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Entity Type | Organization
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Legal Business Name | ABA BEHAVIORAL ADVANCEMENT
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Dates
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Enumeration Date | 02/19/2021
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Last Update Date | 02/19/2021
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Provider Practice Location Address
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Address Line | 3433 SANDS HARBOR TRCE
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City | POMPANO BEACH
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State | FL
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Zip | 33069-6121
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Country | US
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Telephone | 786-391-6772
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Fax | 954-544-4992
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Provider Business Mailing Address
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Address Line | 3433 SANDS HARBOR TRCE
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City | POMPANO BEACH
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State | FL
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Zip | 33069-6121
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Country | US
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Telephone | 786-391-6772
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Fax | 954-544-4992
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Authorized Official
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Title or Position | OWNER
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Name | OTANYS GARCIA
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Credential | ABA
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Telephone | 786-391-6772
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State |
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