| Bridge Aba | |
|
900 Ellis Loop Pocola OK 74902-2428 | |
| (479) 650-3802 | |
| Not Available |
| Full Name | Bridge Aba |
|---|---|
| Speciality | Behavior Analyst |
| Location | 900 Ellis Loop, Pocola, Oklahoma |
| Authorized Official Name and Position | William Keith Montgomery (OWNER/BCBA) |
| Authorized Official Contact | 4796503802 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bridge Aba 6502 Hilltop Rd Van Buren AR 72956-7604 Ph: (479) 650-3802 | Bridge Aba 900 Ellis Loop Pocola OK 74902-2428 Ph: (479) 650-3802 |
| NPI Number | 1447965280 |
|---|---|
| Provider Enumeration Date | 01/17/2023 |
| Last Update Date | 01/30/2023 |
| Certification Date | 01/30/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447965280 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
| 106S00000X | Behavior Technician | (* (Not Available)) | Secondary |