Provider Demographics
NPI:1518680800
Name:ITAV IT TAKES A VILLAGE BEHAVIOR CONSULTING
Entity type:Organization
Organization Name:ITAV IT TAKES A VILLAGE BEHAVIOR CONSULTING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MARIANA
Authorized Official - Middle Name:FRAGA
Authorized Official - Last Name:DEL RIO
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:248-590-1737
Mailing Address - Street 1:5461 BERWYCK DR
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48085-3283
Mailing Address - Country:US
Mailing Address - Phone:248-590-1737
Mailing Address - Fax:
Practice Address - Street 1:5461 BERWYCK DR
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48085-3283
Practice Address - Country:US
Practice Address - Phone:248-590-1737
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-21
Last Update Date:2022-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty