| A Bcba, Llc | |
|
236 Quail Ridge Dr Apt 10 Washington UT 84780-1483 | |
| (909) 276-1072 | |
| Not Available |
| Full Name | A Bcba, Llc |
|---|---|
| Speciality | Behavior Analyst |
| Location | 236 Quail Ridge Dr Apt 10, Washington, Utah |
| Authorized Official Name and Position | Ashley Rose Koontz (OWNER/BCBA) |
| Authorized Official Contact | 9092761072 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| A Bcba, Llc 236 Quail Ridge Dr Apt 10 Washington UT 84780-1483 Ph: (909) 276-1072 | A Bcba, Llc 236 Quail Ridge Dr Apt 10 Washington UT 84780-1483 Ph: (909) 276-1072 |
| NPI Number | 1760011555 |
|---|---|
| Provider Enumeration Date | 04/03/2020 |
| Last Update Date | 05/27/2020 |
| Certification Date | 05/27/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760011555 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
| 106S00000X | Behavior Technician | (* (Not Available)) | Secondary |
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