Provider Demographics
NPI:1417578345
Name:COMPREHENSIVE ABA
Entity Type:Organization
Organization Name:COMPREHENSIVE ABA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE AND CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ANIA
Authorized Official - Middle Name:
Authorized Official - Last Name:PETROVA
Authorized Official - Suffix:
Authorized Official - Credentials:MS, BCBA, LBA, LBS
Authorized Official - Phone:215-359-7874
Mailing Address - Street 1:15 GARRISON PL
Mailing Address - Street 2:
Mailing Address - City:NEWTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18940-1711
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:15 GARRISON PL
Practice Address - Street 2:
Practice Address - City:NEWTOWN
Practice Address - State:PA
Practice Address - Zip Code:18940-1711
Practice Address - Country:US
Practice Address - Phone:215-359-7874
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-01
Last Update Date:2020-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty