Provider Demographics
NPI:1891277661
Name:PETROVA, ANIA SYLVIA (BCBA)
Entity Type:Individual
Prefix:
First Name:ANIA
Middle Name:SYLVIA
Last Name:PETROVA
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 GARRISON PL
Mailing Address - Street 2:
Mailing Address - City:NEWTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18940-1711
Mailing Address - Country:US
Mailing Address - Phone:215-359-7874
Mailing Address - Fax:
Practice Address - Street 1:15 GARRISON PL
Practice Address - Street 2:
Practice Address - City:NEWTOWN
Practice Address - State:PA
Practice Address - Zip Code:18940-1711
Practice Address - Country:US
Practice Address - Phone:215-359-7874
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-29
Last Update Date:2020-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PABH003643103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst