Provider Demographics
NPI:1427810225
Name:AFFABLE ABA PLLC
Entity type:Organization
Organization Name:AFFABLE ABA PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:GOTTFRIED
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:978-771-2863
Mailing Address - Street 1:84 W BROADWAY STE 200
Mailing Address - Street 2:
Mailing Address - City:DERRY
Mailing Address - State:NH
Mailing Address - Zip Code:03038-2323
Mailing Address - Country:US
Mailing Address - Phone:978-771-2863
Mailing Address - Fax:
Practice Address - Street 1:84 W BROADWAY STE 200
Practice Address - Street 2:
Practice Address - City:DERRY
Practice Address - State:NH
Practice Address - Zip Code:03038-2323
Practice Address - Country:US
Practice Address - Phone:978-771-2863
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-26
Last Update Date:2024-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health