| Trail Blazing Aba | |
|
1225 E 24th St Brooklyn NY 11210-4532 | |
| (929) 466-1305 | |
| Not Available |
| Full Name | Trail Blazing Aba |
|---|---|
| Speciality | Behavior Analyst |
| Location | 1225 E 24th St, Brooklyn, New York |
| Authorized Official Name and Position | Sim Ben (MANAGER) |
| Authorized Official Contact | 3476689113 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Trail Blazing Aba 1225 E 24th St Brooklyn NY 11210-4532 Ph: (929) 466-1305 | Trail Blazing Aba 1225 E 24th St Brooklyn NY 11210-4532 Ph: (929) 466-1305 |
| NPI Number | 1053026922 |
|---|---|
| Provider Enumeration Date | 01/16/2023 |
| Last Update Date | 01/16/2023 |
| Certification Date | 01/16/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053026922 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
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