Provider Demographics
NPI:1912662115
Name:PUZZLY ABA LLC
Entity Type:Organization
Organization Name:PUZZLY ABA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VICTORIA
Authorized Official - Middle Name:
Authorized Official - Last Name:GAUTHIER
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:407-613-4272
Mailing Address - Street 1:1166 PALM SPRINGS CT
Mailing Address - Street 2:
Mailing Address - City:PORT ORANGE
Mailing Address - State:FL
Mailing Address - Zip Code:32128-6947
Mailing Address - Country:US
Mailing Address - Phone:407-613-4272
Mailing Address - Fax:
Practice Address - Street 1:1166 PALM SPRINGS CT
Practice Address - Street 2:
Practice Address - City:PORT ORANGE
Practice Address - State:FL
Practice Address - Zip Code:32128-6947
Practice Address - Country:US
Practice Address - Phone:407-613-4272
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-02
Last Update Date:2021-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty