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NPI Code Detail

MEDICARE: BEHAVIOR ANALYTIC YOUTH SERVICES

MEDICARE: BEHAVIOR ANALYTIC YOUTH SERVICES
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103K00000XBehavior Analyst

General Provider Information

NPI Number : 1063006179
Entity Type Code : Organization
Provider Name (Legal Business Name) : BEHAVIOR ANALYTIC YOUTH SERVICES
Provider Business Mailing Address
First Line : 2908 W HILLSBOROUGH AVE
Second Line :
City : TAMPA
State : FL
Zip : 33614-6055
Country : US
Telephone Number : 321-616-6009
Fax Number :
Provider Business Practice Location Address
First Line : 2908 W HILLSBOROUGH AVE
Second Line :
City : TAMPA
State : FL
Zip : 33614-6055
Country : US
Telephone Number : 321-616-6009
Fax Number :
Authorized Official
Title or Position : OWNER/ CLINICAL DIRECTOR
Name : MEGAN KRONE
Credential : BCBA
Telephone Number : 321-616-6009
Provider Enumeration Date : 03/01/2021
Last Update Date : 03/01/2021

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Directions to “BEHAVIOR ANALYTIC YOUTH SERVICES ” Practice Location

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