Provider Demographics
NPI:1659774842
Name:APPLIED VERBAL AND BEHAVIORAL ANALYSIS
Entity Type:Organization
Organization Name:APPLIED VERBAL AND BEHAVIORAL ANALYSIS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JANELLE
Authorized Official - Middle Name:M
Authorized Official - Last Name:GLOVA
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:904-425-9121
Mailing Address - Street 1:154 TOPSAIL DR
Mailing Address - Street 2:
Mailing Address - City:PONTE VEDRA
Mailing Address - State:FL
Mailing Address - Zip Code:32081-4400
Mailing Address - Country:US
Mailing Address - Phone:904-425-9121
Mailing Address - Fax:888-397-0157
Practice Address - Street 1:154 TOPSAIL DR
Practice Address - Street 2:
Practice Address - City:PONTE VEDRA
Practice Address - State:FL
Practice Address - Zip Code:32081-4400
Practice Address - Country:US
Practice Address - Phone:904-425-9121
Practice Address - Fax:888-397-0157
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-01
Last Update Date:2014-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1-13-12871103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty