Provider Demographics
NPI:1184312076
Name:ABA WITH IRIS
Entity type:Organization
Organization Name:ABA WITH IRIS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:IRIS
Authorized Official - Middle Name:
Authorized Official - Last Name:POPESCU
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:801-979-1326
Mailing Address - Street 1:1468 E 8020 S
Mailing Address - Street 2:
Mailing Address - City:SANDY
Mailing Address - State:UT
Mailing Address - Zip Code:84093-6649
Mailing Address - Country:US
Mailing Address - Phone:801-979-1326
Mailing Address - Fax:
Practice Address - Street 1:1468 E 8020 S
Practice Address - Street 2:
Practice Address - City:SANDY
Practice Address - State:UT
Practice Address - Zip Code:84093-6649
Practice Address - Country:US
Practice Address - Phone:801-979-1326
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-27
Last Update Date:2023-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty