Provider Demographics
NPI:1740865781
Name:HAPPY LUNA ABA THERAPY LLC
Entity type:Organization
Organization Name:HAPPY LUNA ABA THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:VENTIMIGLIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-790-5119
Mailing Address - Street 1:5320 NORTHDALE BLVD
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33624-6731
Mailing Address - Country:US
Mailing Address - Phone:813-790-5119
Mailing Address - Fax:
Practice Address - Street 1:5320 NORTHDALE BLVD
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33624-6731
Practice Address - Country:US
Practice Address - Phone:813-790-5119
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-11
Last Update Date:2024-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty