Organization
PH BALANCE BEHAVIORAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRANDON ARTHUR PEREA-HICKAM PHD, BCBA (FOUNDER AND CEO)
(720) 410-4529
Entity
Organization
Contact information
Practice address
954 5TH AVE, LONGMONT, CO 80501-5424
(720) 410-4529
Mailing address
954 5TH AVE, LONGMONT, CO 80501-5424
(720) 410-4529
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
103TB0200X
Cognitive & Behavioral Psychologist
—
—
103TH0100X
Health Service Psychologist
—
—
106E00000X
Assistant Behavior Analyst
—
—
106S00000X
Behavior Technician
—
—
Other
Enumeration date
02/24/2020
Last updated
10/04/2023
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