Provider Demographics
NPI:1063006179
Name:BEHAVIOR ANALYTIC YOUTH SERVICES
Entity Type:Organization
Organization Name:BEHAVIOR ANALYTIC YOUTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MEGAN
Authorized Official - Middle Name:
Authorized Official - Last Name:KRONE
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:321-616-6009
Mailing Address - Street 1:2908 W HILLSBOROUGH AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33614-6055
Mailing Address - Country:US
Mailing Address - Phone:321-616-6009
Mailing Address - Fax:
Practice Address - Street 1:2908 W HILLSBOROUGH AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33614-6055
Practice Address - Country:US
Practice Address - Phone:321-616-6009
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-01
Last Update Date:2021-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty