Provider Demographics
NPI:1184055998
Name:POSITIVE REINFORCEMENT ABA THERAPY, INC
Entity type:Organization
Organization Name:POSITIVE REINFORCEMENT ABA THERAPY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:WAGNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:887-315-8080
Mailing Address - Street 1:49 JENNESS RD
Mailing Address - Street 2:PO BOX 163
Mailing Address - City:EPPING
Mailing Address - State:NH
Mailing Address - Zip Code:03042-2119
Mailing Address - Country:US
Mailing Address - Phone:757-969-0514
Mailing Address - Fax:603-679-8010
Practice Address - Street 1:49 JENNESS RD
Practice Address - Street 2:
Practice Address - City:EPPING
Practice Address - State:NH
Practice Address - Zip Code:03042-2119
Practice Address - Country:US
Practice Address - Phone:757-969-0514
Practice Address - Fax:603-679-8010
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-04
Last Update Date:2013-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health