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General NPI Number Information
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NPI Number | 1831775493
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Entity Type | Organization
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Legal Business Name | BEHAVIOR ANALYSIS CORPORATION
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Dates
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Enumeration Date | 03/23/2021
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Last Update Date | 07/21/2021
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Provider Practice Location Address
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Address Line | 109 COUNTRY CLUB EST
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City | SALEM
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State | IL
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Zip | 62881-3631
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Country | US
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Telephone | 314-740-5639
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Fax |
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Provider Business Mailing Address
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Address Line | 109 COUNTRY CLUB EST
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City | SALEM
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State | IL
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Zip | 62881-3631
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Country | US
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Telephone | 314-740-5639
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | ADEDAYO MOJEED ADENEKAN
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Credential | BCBA
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Telephone | 314-740-5639
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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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Taxonomy #2
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Taxonomy Code | 103TB0200X
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Taxonomy Name | Cognitive & Behavioral Psychologist
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License Number |
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License Number State |
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