| Boomerang Aba Llc | |
|
632 Jamestown St Philadelphia PA 19128-1705 | |
| (908) 461-2177 | |
| Not Available |
| Full Name | Boomerang Aba Llc |
|---|---|
| Speciality | Behavior Analyst |
| Location | 632 Jamestown St, Philadelphia, Pennsylvania |
| Authorized Official Name and Position | Rebecca Crockett (CO-FOUNDERS) |
| Authorized Official Contact | 9084612177 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Boomerang Aba Llc 632 Jamestown St Philadelphia PA 19128-1705 Ph: () - | Boomerang Aba Llc 632 Jamestown St Philadelphia PA 19128-1705 Ph: (908) 461-2177 |
| NPI Number | 1619713807 |
|---|---|
| Provider Enumeration Date | 07/08/2024 |
| Last Update Date | 07/08/2024 |
| Certification Date | 07/07/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619713807 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
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