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Organization
YOUR LIFE ABA VA, LLC
Active
Organization
YOUR LIFE ABA VA, LLC
Active
Parent organization
PROUD MOMENTS LICENSED BEHAVIOR ANALYSTS PLLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
PROUD MOMENTS LICENSED BEHAVIOR ANALYSTS PLLC
Authorized official
MARK A YOST JR. ESQ (GENERAL COUNSEL)
(718) 215-5311
Entity
Organization
Contact information
Practice address
350 5TH AVE STE 6115, NEW YORK, NY 10118-6002
(718) 215-5311
Mailing address
350 5TH AVE STE 6115, NEW YORK, NY 10118-6002
(718) 215-5311
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1023772001
—
VA
Enumeration date
10/26/2021
Last updated
02/13/2025
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