Provider Demographics
NPI:1245738434
Name:BEHAVIORAL MOMENTUM SERVICES LLC
Entity Type:Organization
Organization Name:BEHAVIORAL MOMENTUM SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BEHAVIOR ANALYST
Authorized Official - Prefix:MRS
Authorized Official - First Name:HARBIR
Authorized Official - Middle Name:KAUR
Authorized Official - Last Name:DHILLON
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:661-205-5238
Mailing Address - Street 1:221 S MONTCLAIR ST
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93309-3165
Mailing Address - Country:US
Mailing Address - Phone:661-205-5238
Mailing Address - Fax:
Practice Address - Street 1:221 S MONTCLAIR ST
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93309-3165
Practice Address - Country:US
Practice Address - Phone:661-205-5238
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-23
Last Update Date:2022-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1-17-24995103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty