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Organization

BRIDGING DIFFERENCES ABA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MARY OLSON (ADMINISTRATIVE DIRECTOR)
(916) 280-4678
Entity
Organization

Contact information

Practice address
7520 S SHINGLE RD, SHINGLE SPRINGS, CA 95682-8081
(530) 280-5531
(208) 518-1286
Mailing address
7520 S SHINGLE RD, SHINGLE SPRINGS, CA 95682-8081
(916) 280-5531
(208) 518-1286

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1285018002
NPPES
CA
Enumeration date
03/12/2019
Last updated
05/29/2020
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