Organization
IMPACT LICENSED BEHAVIOR ANALYSIS PLLC
Active
Other names
Impact
Organization subpart
No
Provider details
NPI number
Authorized official
JUDY ROTH MSED, BCBA, LBA (CEO)
(718) 963-0007
Entity
Organization
Contact information
Practice address
134 STOCKTON ST APT 2B, BROOKLYN, NY 11206-5688
(718) 963-0007
Mailing address
134 STOCKTON ST APT 2B, BROOKLYN, NY 11206-5688
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
106E00000X
Assistant Behavior Analyst
—
—
106S00000X
Behavior Technician
—
—
Other
Enumeration date
02/09/2024
Last updated
02/12/2024
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