Provider Demographics
NPI:1326881517
Name:BRAIN AND BODY AUTISM CENTER
Entity type:Organization
Organization Name:BRAIN AND BODY AUTISM CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:MS
Authorized Official - First Name:PRIYA
Authorized Official - Middle Name:
Authorized Official - Last Name:JAMES
Authorized Official - Suffix:
Authorized Official - Credentials:SLP
Authorized Official - Phone:917-324-9244
Mailing Address - Street 1:711 BORELLO WAY
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN VIEW
Mailing Address - State:CA
Mailing Address - Zip Code:94041-2501
Mailing Address - Country:US
Mailing Address - Phone:917-324-9244
Mailing Address - Fax:
Practice Address - Street 1:711 BORELLO WAY
Practice Address - Street 2:
Practice Address - City:MOUNTAIN VIEW
Practice Address - State:CA
Practice Address - Zip Code:94041-2501
Practice Address - Country:US
Practice Address - Phone:917-324-9244
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-14
Last Update Date:2024-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty