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General NPI Number Information
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NPI Number | 1669980454
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Entity Type | Organization
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Legal Business Name | ABA BLUE HOPE CORP
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Dates
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Enumeration Date | 01/16/2018
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Last Update Date | 04/20/2023
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Provider Practice Location Address
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Address Line | 10478 NW 132ND ST
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City | HIALEAH GARDENS
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State | FL
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Zip | 33018-1121
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Country | US
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Telephone | 305-263-0789
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Fax |
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Provider Business Mailing Address
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Address Line | 2638 W 69TH TER
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City | HIALEAH
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State | FL
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Zip | 33016-5483
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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 | CEO
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Name | YANDIRA HERNANDEZ FERNANDEZ
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Credential | BCBA
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Telephone | 305-263-0789
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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 |
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License Number State |
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