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Organization
FLY BEHAVIORAL SERVICES, LICENSED BEHAVIOR ANALYST, PLLC
Active
Organization
FLY BEHAVIORAL SERVICES, LICENSED BEHAVIOR ANALYST, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VIRGINIA WONG BCBA, LBA-NY (FOUNDER)
(646) 524-5984
Entity
Organization
Contact information
Practice address
159 W 118TH ST APT 1D, NEW YORK, NY 10026-1855
(646) 524-5984
Mailing address
111 W 117TH ST APT 3, NEW YORK, NY 10026-1589
(646) 524-5984
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000135
LICENSED BEHAVIOR ANALYST
NY
01
—
1063037
BCBA
—
01
—
1497189104
NPI
—
01
—
1992130017
NPI
—
Enumeration date
09/09/2013
Last updated
02/16/2023
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