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General NPI Number Information
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NPI Number | 1255810990
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Entity Type | Organization
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Legal Business Name | NATIONAL BEHAVIOR ACADEMY
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Dates
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Enumeration Date | 08/13/2018
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Last Update Date | 09/21/2018
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Provider Practice Location Address
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Address Line | 1715 N RAYMOND AVE
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City | PASADENA
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State | CA
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Zip | 91103-1838
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Country | US
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Telephone | 818-318-3035
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Fax |
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Provider Business Mailing Address
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Address Line | 1715 N RAYMOND AVE
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City | PASADENA
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State | CA
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Zip | 91103-1838
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Country | US
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Telephone | 818-318-3035
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Fax |
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | MR. HOLLAND MCWHORTER
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Credential | BCBA
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Telephone | 626-542-5354
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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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