Basic Information
| Provider Information | |||||||||
| NPI: | 1336303049 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | BEHAVIOR ANALYSIS, INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8001 SW 36TH ST | ||||||||
| Address2: | SUITE #9 | ||||||||
| City: | DAVIE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 333281915 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9545777790 | ||||||||
| FaxNumber: | 9545777780 | ||||||||
| Practice Location | |||||||||
| Address1: | 8001 SW 36TH ST | ||||||||
| Address2: | SUITE #9 | ||||||||
| City: | DAVIE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 333281915 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9545777790 | ||||||||
| FaxNumber: | 9545777780 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/11/2008 | ||||||||
| LastUpdateDate: | 07/11/2008 | ||||||||
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| AuthorizedOfficialLastName: | MARUSSICH | ||||||||
| AuthorizedOfficialFirstName: | SILVIA | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | DIRECTOR OF OPERATIONS | ||||||||
| AuthorizedOfficialTelephone: | 9545777790 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
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| AuthorizedOfficialCredential: | MSW | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251S00000X | Y | Agencies | Community/Behavioral Health |
No ID Information.