Provider Demographics
NPI:1003324666
Name:PENNYFARTHING LLC
Entity Type:Organization
Organization Name:PENNYFARTHING LLC
Other - Org Name:PENNYFARTHING APPLIED BEHAVIOR ANALYSIS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:AMY
Authorized Official - Middle Name:KATHERINE
Authorized Official - Last Name:FENWICK
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, LBA, BCBA-D
Authorized Official - Phone:509-850-1080
Mailing Address - Street 1:707 W 7TH AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99204-2832
Mailing Address - Country:US
Mailing Address - Phone:509-850-1080
Mailing Address - Fax:509-461-2532
Practice Address - Street 1:707 W 7TH AVE STE 200
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99204-2832
Practice Address - Country:US
Practice Address - Phone:509-850-1080
Practice Address - Fax:509-461-2532
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-17
Last Update Date:2020-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty