Provider Demographics
NPI:1306398136
Name:OLYMPIC ABA INC.
Entity Type:Organization
Organization Name:OLYMPIC ABA INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BCBA PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:JOAN
Authorized Official - Middle Name:
Authorized Official - Last Name:GITELMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MED, BCBA
Authorized Official - Phone:360-643-0034
Mailing Address - Street 1:4645 BELL STREET
Mailing Address - Street 2:
Mailing Address - City:PORT TOWNSEND
Mailing Address - State:WA
Mailing Address - Zip Code:98368
Mailing Address - Country:US
Mailing Address - Phone:360-643-0034
Mailing Address - Fax:360-208-0665
Practice Address - Street 1:4645 BELL STREET
Practice Address - Street 2:
Practice Address - City:PORT TOWNSEND
Practice Address - State:WA
Practice Address - Zip Code:98368
Practice Address - Country:US
Practice Address - Phone:360-643-0034
Practice Address - Fax:360-208-0665
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-27
Last Update Date:2023-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty