Provider Demographics
NPI:1285267765
Name:GROW BEHAVIOR LLC
Entity type:Organization
Organization Name:GROW BEHAVIOR LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:
Authorized Official - Last Name:KROMAN
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:206-919-6546
Mailing Address - Street 1:271 WINSLOW WAY E UNIT 10405
Mailing Address - Street 2:
Mailing Address - City:BAINBRIDGE ISLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98110-9972
Mailing Address - Country:US
Mailing Address - Phone:206-919-6546
Mailing Address - Fax:
Practice Address - Street 1:4088 MATTSON PL NE
Practice Address - Street 2:
Practice Address - City:BAINBRIDGE ISLAND
Practice Address - State:WA
Practice Address - Zip Code:98110-2224
Practice Address - Country:US
Practice Address - Phone:206-919-6546
Practice Address - Fax:206-451-5681
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-13
Last Update Date:2022-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty