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General NPI Number Information
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NPI Number | 1740142124
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Entity Type | Organization
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Legal Business Name | BRIDGING AUTISM APPLIED BEHAVIOR ANALYSIS PLLC
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Dates
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Enumeration Date | 11/24/2025
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Last Update Date | 11/24/2025
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Provider Practice Location Address
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Address Line | 140 HATHAWAY AVE
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City | ELMONT
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State | NY
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Zip | 11003-2048
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Country | US
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Telephone | 917-518-8965
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Fax | 347-712-3390
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Provider Business Mailing Address
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Address Line | 140 HATHAWAY AVE
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City | ELMONT
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State | NY
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Zip | 11003-2048
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Country | US
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Telephone | 917-518-8965
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Fax | 347-712-3390
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Authorized Official
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Title or Position | LICENSED BEHAVIOR ANALYST
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Name | MRS. VIVIAN MARIE BARRETT
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Credential | BCBA LBA
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Telephone | 917-518-8965
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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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