Provider Demographics
NPI:1942061890
Name:TEDDY BEAR ABA LLC
Entity type:Organization
Organization Name:TEDDY BEAR ABA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER & BCBA
Authorized Official - Prefix:MRS
Authorized Official - First Name:TABITHA
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:PINNER
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:305-315-5248
Mailing Address - Street 1:94825 OVERSEAS HWY UNIT 261
Mailing Address - Street 2:
Mailing Address - City:KEY LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33037-3898
Mailing Address - Country:US
Mailing Address - Phone:305-315-5248
Mailing Address - Fax:850-738-6030
Practice Address - Street 1:94825 OVERSEAS HWY UNIT 261
Practice Address - Street 2:
Practice Address - City:KEY LARGO
Practice Address - State:FL
Practice Address - Zip Code:33037-3898
Practice Address - Country:US
Practice Address - Phone:305-315-5248
Practice Address - Fax:850-738-6030
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-18
Last Update Date:2024-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty