Provider Demographics
NPI:1861148496
Name:PRECISION ABA THERAPY PLLC
Entity type:Organization
Organization Name:PRECISION ABA THERAPY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MIRIAM
Authorized Official - Middle Name:B
Authorized Official - Last Name:GOLDBERG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-691-1296
Mailing Address - Street 1:1042 NE 179TH TER
Mailing Address - Street 2:
Mailing Address - City:NORTH MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33162-1257
Mailing Address - Country:US
Mailing Address - Phone:443-691-1296
Mailing Address - Fax:718-799-5392
Practice Address - Street 1:1042 NE 179TH TER
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33162-1257
Practice Address - Country:US
Practice Address - Phone:443-691-1296
Practice Address - Fax:718-799-5392
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-22
Last Update Date:2022-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty