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General NPI Number Information
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NPI Number | 1972962652
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Entity Type | Organization
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Legal Business Name | APPLIED BEHAVIORAL SPECTRUM SERVICES INC
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Dates
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Enumeration Date | 02/23/2016
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Last Update Date | 02/23/2016
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Provider Practice Location Address
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Address Line | 152-53 10TH AVENUE STE 222
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City | WHITESTONE
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State | NY
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Zip | 11357
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Country | US
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Telephone | 347-732-1145
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Fax | 929-226-6982
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Provider Business Mailing Address
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Address Line | 152-53 10TH AVENUE STE 222
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City | WHITESTONE
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State | NY
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Zip | 11357
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Country | US
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Telephone | 347-732-1145
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Fax | 929-226-6982
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Authorized Official
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Title or Position | CLINICAL DIRECTOR
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Name | NICOLETTA SKLAVOUNAKIS
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Credential | BCBA, LBA
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Telephone | 347-732-1145
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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 | 000918
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License Number State | NY
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