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General NPI Number Information
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NPI Number | 1982361085
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Entity Type | Organization
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Legal Business Name | ABA CLINICAL SUPPORT INC
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Dates
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Enumeration Date | 11/23/2021
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Last Update Date | 02/18/2023
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Provider Practice Location Address
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Address Line | 20541 SW 79TH CT
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City | CUTLER BAY
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State | FL
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Zip | 33189-2184
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Country | US
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Telephone | 561-305-1422
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Fax | 561-516-6538
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Provider Business Mailing Address
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Address Line | 20541 SW 79TH CT
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City | CUTLER BAY
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State | FL
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Zip | 33189-2184
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Country | US
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Telephone | 561-305-1422
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Fax | 561-516-6538
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Authorized Official
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Title or Position | OWNER/OFFICE MANAGER
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Name | DANIEL DIAZ PANDO
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Credential |
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Telephone | 786-991-3706
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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 | 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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