Provider Demographics
NPI:1497486294
Name:MVD APPLIED BEHAVIOR ANALYST PC
Entity type:Organization
Organization Name:MVD APPLIED BEHAVIOR ANALYST PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARISA
Authorized Official - Middle Name:
Authorized Official - Last Name:DECHIARO
Authorized Official - Suffix:
Authorized Official - Credentials:LBA-NYS
Authorized Official - Phone:845-807-7031
Mailing Address - Street 1:209 GARTH RD APT 5E
Mailing Address - Street 2:
Mailing Address - City:SCARSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10583-8004
Mailing Address - Country:US
Mailing Address - Phone:845-807-7031
Mailing Address - Fax:
Practice Address - Street 1:209 GARTH RD APT 5E
Practice Address - Street 2:
Practice Address - City:SCARSDALE
Practice Address - State:NY
Practice Address - Zip Code:10583-8004
Practice Address - Country:US
Practice Address - Phone:845-807-7031
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-22
Last Update Date:2022-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty