Organization
FLY BEHAVIORAL SERVICES, LICENSED BEHAVIOR ANALYST, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VIRGINIA WONG BCBA, LBA-NY (FOUNDER)
(646) 524-5984
Entity
Organization
Contact information
Practice address
159 W 118TH ST APT 1D, NEW YORK, NY 10026-1855
(646) 524-5984
Mailing address
111 W 117TH ST APT 3, NEW YORK, NY 10026-1589
(646) 524-5984
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000135
LICENSED BEHAVIOR ANALYST
NY
01
—
1063037
BCBA
—
01
—
1497189104
NPI
—
01
—
1992130017
NPI
—
Enumeration date
09/09/2013
Last updated
02/16/2023
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