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Organization
YOUR LIFE ABA PA, LLC
Active
Organization
YOUR LIFE ABA PA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEENA STEIN GREENBLATT (CREDENTIALING & INSURANCE CONTRACTI)
(609) 525-4271
Entity
Organization
Contact information
Practice address
1196 E WASHINGTON LN, PHILADELPHIA, PA 19138-1044
(215) 866-0200
(215) 866-0201
Mailing address
2 VILLAGE SQ STE 210, BALTIMORE, MD 21210-1624
(609) 525-4271
(443) 743-3863
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Enumeration date
10/24/2022
Last updated
12/13/2022
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