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General NPI Number Information
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NPI Number | 1922645043
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Entity Type | Organization
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Legal Business Name | HEART & SOUL ABA PLLC
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Dates
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Enumeration Date | 12/09/2019
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Last Update Date | 08/21/2023
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Provider Practice Location Address
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Address Line | 705 E BIDWELL ST STE 2-295
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City | FOLSOM
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State | CA
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Zip | 95630-3315
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Country | US
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Telephone | 602-281-0729
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Fax |
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Provider Business Mailing Address
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Address Line | 4068 MOUNT ROYAL BLVD
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City | ALLISON PARK
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State | PA
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Zip | 15101-2977
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Country | US
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Telephone | 412-552-7609
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SUZAN BONZO
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Credential | BCBA
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Telephone | 602-281-0729
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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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