Provider Demographics
NPI:1457021867
Name:PENNYFARTHING APPLIED BEHAVIOR ANALYSIS
Entity Type:Organization
Organization Name:PENNYFARTHING APPLIED BEHAVIOR ANALYSIS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:FENWICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:509-850-1080
Mailing Address - Street 1:707 W 7TH AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99204-2833
Mailing Address - Country:US
Mailing Address - Phone:509-850-1080
Mailing Address - Fax:509-461-2532
Practice Address - Street 1:707 W 7TH AVE STE 200
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99204-2833
Practice Address - Country:US
Practice Address - Phone:509-850-1080
Practice Address - Fax:509-461-2532
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-16
Last Update Date:2021-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Multi-Specialty