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General NPI Number Information
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NPI Number | 1417532417
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Entity Type | Organization
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Legal Business Name | THE INSTITUTE FOR APPLIED BEHAVIOR ANALYSIS
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Dates
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Enumeration Date | 03/11/2021
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Last Update Date | 03/11/2021
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Provider Practice Location Address
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Address Line | 980 N FEDERAL HWY STE 110
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City | BOCA RATON
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State | FL
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Zip | 33432-2704
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Country | US
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Telephone | 561-401-5163
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Fax | 888-688-9464
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Provider Business Mailing Address
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Address Line | 624 91ST ST
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City | SURFSIDE
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State | FL
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Zip | 33154-3131
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Country | US
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Telephone | 561-401-5163
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Fax | 888-688-9464
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Authorized Official
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Title or Position | OWNER
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Name | MARC TEDOFF
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Credential | PH.D., BCBA
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Telephone | 561-401-5163
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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