Organization
FUNCTIONAL DEVELOPMENT LICENSED BEHAVIORAL ANALYST PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GANNA BARTASHEVA (OWNER)
(718) 732-2164
Entity
Organization
Contact information
Practice address
2148 OCEAN AVE STE 302, BROOKLYN, NY 11229-1484
(718) 732-2164
Mailing address
2148 OCEAN AVE STE 302, BROOKLYN, NY 11229-1484
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
11/28/2023
Last updated
11/28/2023
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