Provider Demographics
NPI:1326790445
Name:AUTISM PRIME THERAPIES
Entity Type:Organization
Organization Name:AUTISM PRIME THERAPIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HARISON
Authorized Official - Middle Name:
Authorized Official - Last Name:MAINA
Authorized Official - Suffix:
Authorized Official - Credentials:MS, BCBA, LABA
Authorized Official - Phone:781-953-2490
Mailing Address - Street 1:54 CUMMINGS PARK STE 312
Mailing Address - Street 2:
Mailing Address - City:WOBURN
Mailing Address - State:MA
Mailing Address - Zip Code:01801-2192
Mailing Address - Country:US
Mailing Address - Phone:781-953-2490
Mailing Address - Fax:781-218-9177
Practice Address - Street 1:54 CUMMINGS PARK STE 312
Practice Address - Street 2:
Practice Address - City:WOBURN
Practice Address - State:MA
Practice Address - Zip Code:01801-2192
Practice Address - Country:US
Practice Address - Phone:781-953-2490
Practice Address - Fax:781-218-9177
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-20
Last Update Date:2022-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty