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General NPI Number Information
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NPI Number | 1326824327
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Entity Type | Organization
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Legal Business Name | GROWING LICENSED BEHAVIOR ANALYST, PLLC
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Dates
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Enumeration Date | 09/05/2023
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Last Update Date | 01/08/2025
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Provider Practice Location Address
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Address Line | 3 HAMPTON DR
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City | CENTER MORICHES
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State | NY
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Zip | 11934-2704
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Country | US
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Telephone | 631-599-9800
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Fax |
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Provider Business Mailing Address
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Address Line | 3 HAMPTON DR
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City | CENTER MORICHES
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State | NY
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Zip | 11934-2704
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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 | FOUNDER
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Name | CARLY PRONSKY
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Credential | MA, LBA, BCBA
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Telephone | 631-599-9800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 252Y00000X
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Taxonomy Name | Early Intervention Provider Agency
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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 | 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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