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General NPI Number Information
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NPI Number | 1700278264
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Entity Type | Organization
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Legal Business Name | RELATIVE BEHAVIOR, INC.
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Dates
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Enumeration Date | 02/20/2015
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Last Update Date | 02/20/2015
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Provider Practice Location Address
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Address Line | 20602 JAY CARROLL DR
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City | SANTA CLARITA
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State | CA
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Zip | 91350-1985
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Country | US
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Telephone | 818-689-5056
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Fax |
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Provider Business Mailing Address
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Address Line | 20602 JAY CARROLL DR
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City | SANTA CLARITA
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State | CA
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Zip | 91350-1985
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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 | OWNER/CLINICAL DIRECTOR
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Name | MRS. RENEE CANDAN
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Credential | MS, BCBA
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Telephone | 818-689-5056
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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 | BCBA# 1-12-11964
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License Number State | CA
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