Provider Demographics
NPI:1841888047
Name:TREASURED HEARTS ABA LLC
Entity type:Organization
Organization Name:TREASURED HEARTS ABA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:LYN
Authorized Official - Last Name:REZA
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA, LBA
Authorized Official - Phone:540-538-6618
Mailing Address - Street 1:18025 GRAND PROSPERITY DR
Mailing Address - Street 2:
Mailing Address - City:VENICE
Mailing Address - State:FL
Mailing Address - Zip Code:34293-4966
Mailing Address - Country:US
Mailing Address - Phone:703-596-2237
Mailing Address - Fax:540-744-1091
Practice Address - Street 1:12512 SHERWOOD FOREST DR
Practice Address - Street 2:
Practice Address - City:CULPEPER
Practice Address - State:VA
Practice Address - Zip Code:22701-1663
Practice Address - Country:US
Practice Address - Phone:540-538-7316
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-05
Last Update Date:2024-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty