Provider Demographics
NPI:1942030036
Name:BRANCH BEYOND ABA CONSULTING AND SERVICES
Entity type:Organization
Organization Name:BRANCH BEYOND ABA CONSULTING AND SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO, BCBA, LBA
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARNEICIA
Authorized Official - Middle Name:DIANE
Authorized Official - Last Name:BRANCH
Authorized Official - Suffix:
Authorized Official - Credentials:MED,BCBA, LBA
Authorized Official - Phone:757-232-3991
Mailing Address - Street 1:7 FOREST HILL DR
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23185-4330
Mailing Address - Country:US
Mailing Address - Phone:757-232-3991
Mailing Address - Fax:
Practice Address - Street 1:7 FOREST HILL DR
Practice Address - Street 2:
Practice Address - City:WILLIAMSBURG
Practice Address - State:VA
Practice Address - Zip Code:23185-4330
Practice Address - Country:US
Practice Address - Phone:757-232-3675
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-05
Last Update Date:2024-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health