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General NPI Number Information
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NPI Number | 1174884134
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Entity Type | Organization
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Legal Business Name | APPLIED BEHAVIOR APPROACHES OF TAMPA BAY INC
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Dates
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Enumeration Date | 06/06/2012
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Last Update Date | 08/05/2021
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Provider Practice Location Address
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Address Line | 18946 NORTH DALE MABRY
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City | LUTZ
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State | FL
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Zip | 33548
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Country | US
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Telephone | 727-241-0246
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Fax | 727-240-4720
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Provider Business Mailing Address
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Address Line | 1353 LOTUS PATH
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City | CLEARWATER
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State | FL
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Zip | 33756
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Country | US
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Telephone | 727-241-0246
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Fax | 727-240-4720
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Authorized Official
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Title or Position | OWNER; BOARD CERTIFIED BEHAVIOR ANA
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Name | ROBIN LANE DEHAINAUT
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Credential | M.A., BCBA
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Telephone | 727-241-0246
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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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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 1-09-5814
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License Number State | FL
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