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General NPI Number Information
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NPI Number | 1740871300
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Entity Type | Organization
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Legal Business Name | AJA POSITIVE OUTCOMES INC.
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Dates
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Enumeration Date | 01/27/2021
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Last Update Date | 01/27/2021
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Provider Practice Location Address
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Address Line | 8310 149TH AVE
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City | HOWARD BEACH
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State | NY
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Zip | 11414-1215
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Country | US
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Telephone | 929-456-7405
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Fax |
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Provider Business Mailing Address
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Address Line | 8310 149TH AVE
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City | HOWARD BEACH
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State | NY
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Zip | 11414-1215
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Country | US
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Telephone | 929-456-7405
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Fax |
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Authorized Official
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Title or Position | PARTNER
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Name | MR. ANDREW BAUMANN
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Credential | CASAC, ICADC, FAPA
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Telephone | 929-456-7405
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number |
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License Number State |
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