Provider Demographics
NPI:1417412511
Name:VIRTUE ABA LLC
Entity Type:Organization
Organization Name:VIRTUE ABA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:CHAU-CIONTUT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-451-6423
Mailing Address - Street 1:11 FOX RUN RD
Mailing Address - Street 2:
Mailing Address - City:NORWALK
Mailing Address - State:CT
Mailing Address - Zip Code:06850-2308
Mailing Address - Country:US
Mailing Address - Phone:203-451-6423
Mailing Address - Fax:
Practice Address - Street 1:11 FOX RUN RD
Practice Address - Street 2:
Practice Address - City:NORWALK
Practice Address - State:CT
Practice Address - Zip Code:06850-2308
Practice Address - Country:US
Practice Address - Phone:203-451-6423
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-04
Last Update Date:2019-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty