Provider Demographics
NPI:1043920184
Name:BLESSED ABA THERAPY SERVICE INC
Entity type:Organization
Organization Name:BLESSED ABA THERAPY SERVICE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANA
Authorized Official - Middle Name:
Authorized Official - Last Name:DIAZ HERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:786-886-6446
Mailing Address - Street 1:21002 IRONCREST LN
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77388-4321
Mailing Address - Country:US
Mailing Address - Phone:786-886-6446
Mailing Address - Fax:786-685-2588
Practice Address - Street 1:21002 IRONCREST LN
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77388-4321
Practice Address - Country:US
Practice Address - Phone:786-886-6446
Practice Address - Fax:786-685-2588
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-30
Last Update Date:2024-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty