Provider Demographics
NPI:1427873504
Name:ADVANCED BEHAVIOR ANALYSIS INC
Entity type:Organization
Organization Name:ADVANCED BEHAVIOR ANALYSIS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BRITTANY
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:PROBERT
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:385-695-2203
Mailing Address - Street 1:8031 S 700 E
Mailing Address - Street 2:
Mailing Address - City:SANDY
Mailing Address - State:UT
Mailing Address - Zip Code:84070-0555
Mailing Address - Country:US
Mailing Address - Phone:385-695-2203
Mailing Address - Fax:877-649-1086
Practice Address - Street 1:102 S TEJON ST STE 2200
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80903-2231
Practice Address - Country:US
Practice Address - Phone:385-695-2203
Practice Address - Fax:877-649-1086
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-22
Last Update Date:2024-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty