| Premierpath Aba Llc | |
|
13 Greywood Dr Orangeburg NY 10962-2419 | |
| (452) 133-8158 | |
| Not Available |
| Full Name | Premierpath Aba Llc |
|---|---|
| Speciality | Behavior Analyst |
| Location | 13 Greywood Dr, Orangeburg, New York |
| Authorized Official Name and Position | Jessica Lisanti (OWNER & DIRECTOR) |
| Authorized Official Contact | 8454679452 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Premierpath Aba Llc 13 Greywood Dr Orangeburg NY 10962-2419 Ph: (845) 467-9452 | Premierpath Aba Llc 13 Greywood Dr Orangeburg NY 10962-2419 Ph: (452) 133-8158 |
| NPI Number | 1336923317 |
|---|---|
| Provider Enumeration Date | 08/22/2023 |
| Last Update Date | 08/22/2023 |
| Certification Date | 08/22/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336923317 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
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