Provider Demographics
NPI:1609598010
Name:ABA THERAPY OF ST LUCIE INC
Entity Type:Organization
Organization Name:ABA THERAPY OF ST LUCIE INC
Other - Org Name:ABA THERAPY OF ST LUCIE INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:BARRIOS
Authorized Official - Suffix:
Authorized Official - Credentials:MS CCC SLP
Authorized Official - Phone:772-237-1731
Mailing Address - Street 1:2678 SW ACCO RD
Mailing Address - Street 2:
Mailing Address - City:PORT ST LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34953-2813
Mailing Address - Country:US
Mailing Address - Phone:772-621-0061
Mailing Address - Fax:
Practice Address - Street 1:130 S INDIAN RIVER DR STE 202-231
Practice Address - Street 2:
Practice Address - City:FORT PIERCE
Practice Address - State:FL
Practice Address - Zip Code:34950-4343
Practice Address - Country:US
Practice Address - Phone:772-237-1731
Practice Address - Fax:772-209-5871
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-13
Last Update Date:2022-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty