Provider Demographics
NPI:1366638470
Name:BEHAVIORAL & ACADEMIC INTERVENTIONS
Entity Type:Organization
Organization Name:BEHAVIORAL & ACADEMIC INTERVENTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BRYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:DAVEY
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, BCBA
Authorized Official - Phone:602-309-7522
Mailing Address - Street 1:4244 E WASHINGTON CT
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85234-7791
Mailing Address - Country:US
Mailing Address - Phone:602-309-7522
Mailing Address - Fax:
Practice Address - Street 1:4244 E WASHINGTON CT
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85234-7791
Practice Address - Country:US
Practice Address - Phone:602-309-7522
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-21
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1-04-1491101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ=========-85233-A001OtherTRIWEST