Provider Demographics
NPI:1043551575
Name:LY, LINH BOI (BCBA)
Entity type:Individual
Prefix:
First Name:LINH
Middle Name:BOI
Last Name:LY
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:721 N VULCAN AVE
Mailing Address - Street 2:SUITE 208
Mailing Address - City:ENCINITAS
Mailing Address - State:CA
Mailing Address - Zip Code:92024-2190
Mailing Address - Country:US
Mailing Address - Phone:760-634-1125
Mailing Address - Fax:760-634-1530
Practice Address - Street 1:721 N VULCAN AVE
Practice Address - Street 2:SUITE 208
Practice Address - City:ENCINITAS
Practice Address - State:CA
Practice Address - Zip Code:92024-2190
Practice Address - Country:US
Practice Address - Phone:760-634-1125
Practice Address - Fax:760-634-1530
Is Sole Proprietor?:No
Enumeration Date:2013-03-07
Last Update Date:2014-02-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CABCBA 1-13-13304103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst