Provider Demographics
NPI:1851001796
Name:PROGRESSIVE BEHAVIOR ANALYST CORP
Entity Type:Organization
Organization Name:PROGRESSIVE BEHAVIOR ANALYST CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MIRTHA
Authorized Official - Middle Name:
Authorized Official - Last Name:NEIRA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-305-0279
Mailing Address - Street 1:13707 SW 66TH ST APT 408
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33183-2240
Mailing Address - Country:US
Mailing Address - Phone:305-305-0279
Mailing Address - Fax:305-752-7673
Practice Address - Street 1:13707 SW 66TH ST APT 408
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33183-2240
Practice Address - Country:US
Practice Address - Phone:305-305-0279
Practice Address - Fax:305-752-7673
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-01
Last Update Date:2022-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty