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Organization
COASTAL ABA, LLC
Active
Organization
COASTAL ABA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAUREN ALTMAN BRUM BCBA (OWNER, BEHAVIOR ANALYST)
(727) 888-3296
Entity
Organization
Contact information
Practice address
6001 41ST AVE N, ST PETERSBURG, FL 33709-5221
(727) 656-6045
(727) 656-6045
Mailing address
3135 1ST AVE N, PO BOX 12844, ST. PETERSBURG, FL 33730
(727) 999-0583
(855) 306-2505
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1073972451
—
FL
05
—
1700266871
—
FL
Enumeration date
09/23/2017
Last updated
09/23/2017
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