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Organization

BRIDGE ABA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
WILLIAM KEITH MONTGOMERY MS BCBA (OWNER/BCBA)
(479) 650-3802
Entity
Organization

Contact information

Practice address
900 ELLIS LOOP, POCOLA, OK 74902-2428
(479) 650-3802
Mailing address
6502 HILLTOP RD, VAN BUREN, AR 72956-7604
(479) 650-3802

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
106S00000X
Behavior Technician

Other

Enumeration date
01/17/2023
Last updated
01/30/2023
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