Provider Demographics
NPI:1336698299
Name:APPLIED BEHAVIORAL LEARNING SERVICES
Entity Type:Organization
Organization Name:APPLIED BEHAVIORAL LEARNING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIELA
Authorized Official - Middle Name:
Authorized Official - Last Name:VARGAS-IRWIN
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD, BCBA, LABA
Authorized Official - Phone:617-283-1276
Mailing Address - Street 1:1 CHRYSLER RD
Mailing Address - Street 2:APT 1001
Mailing Address - City:NATICK
Mailing Address - State:MA
Mailing Address - Zip Code:01760-1650
Mailing Address - Country:US
Mailing Address - Phone:617-283-1276
Mailing Address - Fax:
Practice Address - Street 1:1 CHRYSLER RD
Practice Address - Street 2:APT 1001
Practice Address - City:NATICK
Practice Address - State:MA
Practice Address - Zip Code:01760-1650
Practice Address - Country:US
Practice Address - Phone:617-283-1276
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-03
Last Update Date:2016-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1123103K00000X
MA949103K00000X
MA749103K00000X
MA1002103K00000X
MA7783103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty