Organization
MOUNTAIN STATE APPLIED BEHAVIOR ANALYSIS LLC
Active
Other names
Mountain State ABA
Organization subpart
No
Provider details
NPI number
Authorized official
EZRA HALL (OWNER)
(304) 290-4262
Entity
Organization
Contact information
Practice address
1010 WINCHESTER AVE, MARTINSBURG, WV 25401-1683
(304) 290-4262
(304) 212-0627
Mailing address
PO BOX 442, SHEPHERDSTOWN, WV 25443-0442
(304) 290-4262
(304) 212-0627
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-14-16309
WV
Other
Enumeration date
12/30/2016
Last updated
01/04/2022
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