Provider Demographics
NPI:1275102931
Name:ROTTENBERG, TOVA (MED BCBA, COBA)
Entity Type:Individual
Prefix:MRS
First Name:TOVA
Middle Name:
Last Name:ROTTENBERG
Suffix:
Gender:F
Credentials:MED BCBA, COBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4358 BAINTREE RD
Mailing Address - Street 2:
Mailing Address - City:UNIVERSITY HTS
Mailing Address - State:OH
Mailing Address - Zip Code:44118-3931
Mailing Address - Country:US
Mailing Address - Phone:216-691-0020
Mailing Address - Fax:
Practice Address - Street 1:4358 BAINTREE RD
Practice Address - Street 2:
Practice Address - City:UNIVERSITY HTS
Practice Address - State:OH
Practice Address - Zip Code:44118-3931
Practice Address - Country:US
Practice Address - Phone:216-691-0020
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-17
Last Update Date:2021-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst