Provider Demographics
NPI:1194019489
Name:DOOLABH, AJIT C (PHD, BCBA)
Entity Type:Individual
Prefix:DR
First Name:AJIT
Middle Name:C
Last Name:DOOLABH
Suffix:
Gender:M
Credentials:PHD, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 BRITTANIA DR
Mailing Address - Street 2:
Mailing Address - City:DANBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06811-2613
Mailing Address - Country:US
Mailing Address - Phone:203-233-1211
Mailing Address - Fax:
Practice Address - Street 1:45 BRITTANIA DR
Practice Address - Street 2:
Practice Address - City:DANBURY
Practice Address - State:CT
Practice Address - Zip Code:06811-2613
Practice Address - Country:US
Practice Address - Phone:203-233-1211
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-03
Last Update Date:2011-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1-05-2201103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst