Organization
BASIL THERAPY
Active
Other names
TheraDriver
Organization subpart
No
Provider details
NPI number
Authorized official
MAREIKO AU BCBA (CHIEF OPERATIONS OFFICER)
(626) 354-3759
Entity
Organization
Contact information
Practice address
1 BLUXOME ST APT 411, SAN FRANCISCO, CA 94107-5523
(630) 306-4136
Mailing address
1 BLUXOME ST APT 411, SAN FRANCISCO, CA 94107-5523
(630) 306-4136
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
05/29/2024
Last updated
05/29/2024
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