Provider Demographics
NPI:1932853256
Name:IMPRINTS ABA SERVICES
Entity type:Organization
Organization Name:IMPRINTS ABA SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, BCBA, LABA
Authorized Official - Prefix:
Authorized Official - First Name:CORY
Authorized Official - Middle Name:
Authorized Official - Last Name:MITCHELL
Authorized Official - Suffix:
Authorized Official - Credentials:MS, BCBA, LABA
Authorized Official - Phone:339-788-7980
Mailing Address - Street 1:8 BLUE JAY LN
Mailing Address - Street 2:
Mailing Address - City:RAYNHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02767-6139
Mailing Address - Country:US
Mailing Address - Phone:339-788-7980
Mailing Address - Fax:
Practice Address - Street 1:8 BLUE JAY LN
Practice Address - Street 2:
Practice Address - City:RAYNHAM
Practice Address - State:MA
Practice Address - Zip Code:02767-6139
Practice Address - Country:US
Practice Address - Phone:339-788-7980
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:IMPRINTS ABA SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-02-06
Last Update Date:2022-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty