Provider Demographics
NPI:1629692017
Name:MY BEHAVIOR ANALYST INC
Entity Type:Organization
Organization Name:MY BEHAVIOR ANALYST INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:FARAH
Authorized Official - Middle Name:ZAHIRA
Authorized Official - Last Name:BACCHUS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, BCBA-D
Authorized Official - Phone:773-454-1571
Mailing Address - Street 1:8040 PRAISE DR
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33625-3744
Mailing Address - Country:US
Mailing Address - Phone:773-454-1571
Mailing Address - Fax:813-688-0528
Practice Address - Street 1:8040 PRAISE DR
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33625-3744
Practice Address - Country:US
Practice Address - Phone:773-454-1571
Practice Address - Fax:813-688-0528
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-02
Last Update Date:2023-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty