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General NPI Number Information
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NPI Number | 1548734056
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Entity Type | Organization
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Legal Business Name | IRIS BEHAVIOR SERVICES LLC
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Dates
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Enumeration Date | 01/17/2019
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Last Update Date | 11/16/2024
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Provider Practice Location Address
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Address Line | 5579 N TUCSON TER
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City | BEVERLY HILLS
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State | FL
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Zip | 34465-2102
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Country | US
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Telephone | 720-670-9269
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Fax |
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Provider Business Mailing Address
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Address Line | 5579 N TUCSON TER
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City | BEVERLY HILLS
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State | FL
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Zip | 34465-2102
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Country | US
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Telephone | 720-670-9269
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | TRACY NELSON
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Credential | BCBA
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Telephone | 720-670-9269
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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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