Provider Demographics
NPI:1992442529
Name:EARLY YEARS ABA THERAPY LLC
Entity type:Organization
Organization Name:EARLY YEARS ABA THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BEHAVIOR ANALYST
Authorized Official - Prefix:
Authorized Official - First Name:ZOHREH
Authorized Official - Middle Name:
Authorized Official - Last Name:AHMADZADEH
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:301-525-5040
Mailing Address - Street 1:10404 DALEBROOKE LN
Mailing Address - Street 2:
Mailing Address - City:POTOMAC
Mailing Address - State:MD
Mailing Address - Zip Code:20854-6413
Mailing Address - Country:US
Mailing Address - Phone:301-525-5040
Mailing Address - Fax:
Practice Address - Street 1:10404 DALEBROOKE LN
Practice Address - Street 2:
Practice Address - City:POTOMAC
Practice Address - State:MD
Practice Address - Zip Code:20854-6413
Practice Address - Country:US
Practice Address - Phone:301-525-5040
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-16
Last Update Date:2022-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty