Provider Demographics
NPI:1073236311
Name:NEUROINCLUSIVE CONTEXTUAL BEHAVIOR COALITION
Entity Type:Organization
Organization Name:NEUROINCLUSIVE CONTEXTUAL BEHAVIOR COALITION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:COIMBRA
Authorized Official - Suffix:
Authorized Official - Credentials:MS, BCBA, LBA
Authorized Official - Phone:443-616-4170
Mailing Address - Street 1:5436 21ST AVE SW
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98106-1413
Mailing Address - Country:US
Mailing Address - Phone:443-616-4170
Mailing Address - Fax:
Practice Address - Street 1:5436 21ST AVE SW
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98106-1413
Practice Address - Country:US
Practice Address - Phone:443-616-4170
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-21
Last Update Date:2022-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty