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General NPI Number Information
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NPI Number | 1164179206
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Entity Type | Organization
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Legal Business Name | JOYFUL BEHAVIOR ANALYTIC SERVICES
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Dates
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Enumeration Date | 03/08/2022
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Last Update Date | 05/21/2025
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Provider Practice Location Address
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Address Line | 105 PINE BLUFF RD STE 7A
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City | SALISBURY
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State | MD
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Zip | 21801-7114
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Country | US
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Telephone | 302-466-5404
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Fax |
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Provider Business Mailing Address
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Address Line | 38478 BARBERRY ST
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City | DELMAR
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State | DE
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Zip | 19940-3531
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Country | US
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Telephone | 661-478-9586
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Fax |
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Authorized Official
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Title or Position | PRESIDENT, FOUNDER
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Name | CHRYSTLE MEDINA
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Credential | BCBA, LBA
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Telephone | 661-478-9586
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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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