Basic Information
| Provider Information | |||||||||
| NPI: | 1528510229 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | APPLIED BEHAVIORAL LEARNING SERVICES | ||||||||
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| Mailing Information | |||||||||
| Address1: | 109 OAK ST | ||||||||
| Address2: | |||||||||
| City: | NEWTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 024641492 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6179165771 | ||||||||
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| Practice Location | |||||||||
| Address1: | 109 OAK ST | ||||||||
| Address2: | |||||||||
| City: | NEWTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 024641492 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6179165771 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/28/2016 | ||||||||
| LastUpdateDate: | 10/28/2016 | ||||||||
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| AuthorizedOfficialLastName: | KWONG | ||||||||
| AuthorizedOfficialFirstName: | LILY | ||||||||
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| AuthorizedOfficialTitleorPosition: | BEHAVIOR THERAPIST | ||||||||
| AuthorizedOfficialTelephone: | 6178200317 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MS. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251S00000X | Y | Agencies | Community/Behavioral Health |
No ID Information.