| Granite State Aba Services | |
|
170 Kearsarge Rd North Conway NH 03860-5331 | |
| (603) 356-6616 | |
| (603) 356-6617 |
| Full Name | Granite State Aba Services |
|---|---|
| Speciality | Behavior Analyst |
| Location | 170 Kearsarge Rd, North Conway, New Hampshire |
| Authorized Official Name and Position | Ariana Lopez (ADMIN) |
| Authorized Official Contact | 7143343839 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Granite State Aba Services Po Box 955 Glen NH 03838-0955 Ph: (603) 356-6616 | Granite State Aba Services 170 Kearsarge Rd North Conway NH 03860-5331 Ph: (603) 356-6616 |
| NPI Number | 1063964930 |
|---|---|
| Provider Enumeration Date | 10/26/2016 |
| Last Update Date | 10/26/2023 |
| Certification Date | 10/26/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063964930 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
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