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General NPI Number Information
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NPI Number | 1497262968
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Entity Type | Organization
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Legal Business Name | BEHAVIOR LEARNING INTERVENTION STRATEGIES AND SOLUTIONS
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Dates
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Enumeration Date | 01/05/2018
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Last Update Date | 01/05/2018
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Provider Practice Location Address
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Address Line | 12920 CENTRAL AVE UNIT 204
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City | HAWTHORNE
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State | CA
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Zip | 90250-5888
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Country | US
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Telephone | 818-599-6100
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Fax |
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Provider Business Mailing Address
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Address Line | 12920 CENTRAL AVE UNIT 204
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City | HAWTHORNE
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State | CA
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Zip | 90250-5888
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Country | US
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Telephone | 818-599-6100
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | HOLLY MASCELLI
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Credential |
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Telephone | 818-599-6100
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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 | 1-11-8225
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License Number State | CA
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