Provider Demographics
NPI:1013623297
Name:PAIR WITH ABA LLC
Entity Type:Organization
Organization Name:PAIR WITH ABA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:PERLA
Authorized Official - Middle Name:
Authorized Official - Last Name:TIKO
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:267-761-7479
Mailing Address - Street 1:301 E GIRARD AVE STE 2
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19125-3918
Mailing Address - Country:US
Mailing Address - Phone:267-667-5808
Mailing Address - Fax:267-668-8900
Practice Address - Street 1:301 E GIRARD AVE STE 2
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19125-3918
Practice Address - Country:US
Practice Address - Phone:267-667-5808
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-30
Last Update Date:2024-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities