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General NPI Number Information
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NPI Number | 1396090494
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Entity Type | Individual
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Provider Name | SOFIJA SONJA GALIC M.A. BCBA CBA
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Gender | Female
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Dates
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Enumeration Date | 07/16/2012
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Last Update Date | 11/29/2023
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Provider Practice Location Address
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Address Line | 120 BENCHELY PLACE FRONT 2
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City | BRONX
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State | NY
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Zip | 10475-3402
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Country | US
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Telephone | 347-843-7760
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Fax | 347-843-7780
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Provider Business Mailing Address
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Address Line | 151 1ST AVE APT APT 117
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City | NEW YORK
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State | NY
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Zip | 10003
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Country | US
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Telephone | 917-583-3730
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Fax | 518-777-3293
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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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 | 002067-01
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License Number State | NY
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