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General NPI Number Information
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NPI Number | 1720636640
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Entity Type | Organization
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Legal Business Name | BY YOUR SIDE SERVICES LICENSED APPLIED BEHAVIOR ANALYST PRACTICE PLLC
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Dates
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Enumeration Date | 09/04/2019
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Last Update Date | 09/04/2019
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Provider Practice Location Address
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Address Line | 105 W. 86TH STREET #228
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City | NEW YORK
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State | NY
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Zip | 10024
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Country | US
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Telephone | 917-841-8869
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Fax |
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Provider Business Mailing Address
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Address Line | 105 W. 86TH STREET #228
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City | NEW YORK
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State | NY
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Zip | 10024
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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 | CLINICAL DIRECTOR
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Name | BECCA YURE
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Credential | M.ED., BCBA, LBA
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Telephone | 917-841-8869
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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