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NPI Code Detail

MEDICARE: EXPERT ABA CONSULTING, LLC

MEDICARE: EXPERT ABA CONSULTING, LLC
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 Analyst1-14-9821FL

General Provider Information

NPI Number : 1235650516
Entity Type Code : Organization
Provider Name (Legal Business Name) : EXPERT ABA CONSULTING, LLC
Provider Business Mailing Address
First Line : 225 S LAKE AVE STE 300
Second Line :
City : PASADENA
State : CA
Zip : 91101-3009
Country : US
Telephone Number : 626-432-5491
Fax Number :
Provider Business Practice Location Address
First Line : 225 S LAKE AVE STE 300
Second Line :
City : PASADENA
State : CA
Zip : 91101-3009
Country : US
Telephone Number : 626-432-5491
Fax Number :
Authorized Official
Title or Position : CLINICAL DIRECTOR
Name : DR. LAWRENCE TANIFORM
Credential : BCBA
Telephone Number : 626-432-5491
Provider Enumeration Date : 06/27/2017
Last Update Date : 07/21/2022

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Directions to “EXPERT ABA CONSULTING, LLC ” Practice Location

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