Provider Demographics
NPI:1528775590
Name:ATYPICAL BEHAVIOR ANALYSIS CORP
Entity type:Organization
Organization Name:ATYPICAL BEHAVIOR ANALYSIS CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BEATRIZ
Authorized Official - Middle Name:
Authorized Official - Last Name:ROBAINA BOUZA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-370-7501
Mailing Address - Street 1:801 W BAY DR STE 405
Mailing Address - Street 2:
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33770-3220
Mailing Address - Country:US
Mailing Address - Phone:786-370-7501
Mailing Address - Fax:
Practice Address - Street 1:801 W BAY DR STE 405
Practice Address - Street 2:
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33770-3220
Practice Address - Country:US
Practice Address - Phone:786-370-7501
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-31
Last Update Date:2023-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty