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General NPI Number Information
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NPI Number | 1699650135
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Entity Type | Organization
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Legal Business Name | ACTIVE ABA LLC
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Dates
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Enumeration Date | 08/06/2025
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Last Update Date | 08/11/2025
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Provider Practice Location Address
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Address Line | 440 MONTICELLO AVE STE 1802
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City | NORFOLK
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State | VA
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Zip | 23510-2670
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Country | US
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Telephone | 929-631-2690
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Fax |
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Provider Business Mailing Address
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Address Line | 927 PARK LN
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City | VALLEY STREAM
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State | NY
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Zip | 11581-2739
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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 | FOUNDER
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Name | DOVID BOROWSKI
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Credential |
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Telephone | 929-631-2690
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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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