Provider Demographics
NPI:1639894371
Name:GARD ABA CONSULTING, LLC
Entity Type:Organization
Organization Name:GARD ABA CONSULTING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BCBA-D
Authorized Official - Prefix:DR
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:GARD
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, BCBA-D
Authorized Official - Phone:612-432-4135
Mailing Address - Street 1:2525 SE 41ST AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97202-1616
Mailing Address - Country:US
Mailing Address - Phone:612-432-4135
Mailing Address - Fax:
Practice Address - Street 1:2525 SE 41ST AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97202-1616
Practice Address - Country:US
Practice Address - Phone:612-432-4135
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-05
Last Update Date:2022-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty