Provider Demographics
NPI:1164160479
Name:BEHAVIOR DYNAMICS - ABA SERVICES LLC
Entity Type:Organization
Organization Name:BEHAVIOR DYNAMICS - ABA SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BEHAVIOR ANALYST
Authorized Official - Prefix:MS
Authorized Official - First Name:STACY
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:MONTALTO
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:201-681-1013
Mailing Address - Street 1:477 NORTH AVE
Mailing Address - Street 2:
Mailing Address - City:WOOD RIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07075-2334
Mailing Address - Country:US
Mailing Address - Phone:120-168-1101
Mailing Address - Fax:
Practice Address - Street 1:477 NORTH AVE
Practice Address - Street 2:
Practice Address - City:WOOD RIDGE
Practice Address - State:NJ
Practice Address - Zip Code:07075-2334
Practice Address - Country:US
Practice Address - Phone:120-168-1101
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-25
Last Update Date:2022-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty