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General NPI Number Information
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NPI Number | 1760067086
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Entity Type | Organization
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Legal Business Name | PROFESSIONAL BEHAVIOR ANALYSIS INC
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Dates
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Enumeration Date | 03/17/2021
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Last Update Date | 05/17/2023
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Provider Practice Location Address
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Address Line | 504 E BAKER ST STE 1
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City | PLANT CITY
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State | FL
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Zip | 33563-3558
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Country | US
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Telephone | 813-704-6297
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Fax | 813-200-1271
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Provider Business Mailing Address
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Address Line | 504 E BAKER ST STE 1
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City | PLANT CITY
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State | FL
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Zip | 33563-3558
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Country | US
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Telephone | 813-704-6297
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Fax | 813-200-1271
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Authorized Official
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Title or Position | PRESIDENT
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Name | LUISA MARIA HERNANDEZ LOPEZ
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Credential |
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Telephone | 305-764-0561
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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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