| Tahoe Basin Behavior Analysis, Llc | |
|
1105 Margaret Ave South Lake Tahoe CA 96150-6242 | |
| (530) 318-0824 | |
| Not Available |
| Full Name | Tahoe Basin Behavior Analysis, Llc |
|---|---|
| Speciality | Behavior Analyst |
| Location | 1105 Margaret Ave, South Lake Tahoe, California |
| Authorized Official Name and Position | Jillian Labrie (OWNER) |
| Authorized Official Contact | 5303180824 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tahoe Basin Behavior Analysis, Llc Po Box 13976 South Lake Tahoe CA 96151-3976 Ph: () - | Tahoe Basin Behavior Analysis, Llc 1105 Margaret Ave South Lake Tahoe CA 96150-6242 Ph: (530) 318-0824 |
| NPI Number | 1578061826 |
|---|---|
| Provider Enumeration Date | 01/31/2018 |
| Last Update Date | 03/07/2021 |
| Certification Date | 03/07/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578061826 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (California) | Primary |
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