Provider Demographics
NPI:1629566351
Name:OPTIMA BEHAVIORAL CONSULTING, LLC
Entity Type:Organization
Organization Name:OPTIMA BEHAVIORAL CONSULTING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ARIELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:KUZDAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:520-500-7505
Mailing Address - Street 1:1955 W GRANT RD STE 180
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85745-1475
Mailing Address - Country:US
Mailing Address - Phone:844-333-6642
Mailing Address - Fax:520-333-3060
Practice Address - Street 1:1955 W GRANT RD STE 180
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85745-1475
Practice Address - Country:US
Practice Address - Phone:844-333-6642
Practice Address - Fax:520-333-3060
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:OPTIMA BEHAVIORAL CONSULTING
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-04-27
Last Update Date:2018-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty