Provider Demographics
NPI:1679380125
Name:ORANGE FOX ABA
Entity type:Organization
Organization Name:ORANGE FOX ABA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BCBA, PRACTICE LEADER
Authorized Official - Prefix:MS
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:
Authorized Official - Last Name:ANDREW
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:678-602-6023
Mailing Address - Street 1:12655 FOREST GREEN DR
Mailing Address - Street 2:
Mailing Address - City:ELBERT
Mailing Address - State:CO
Mailing Address - Zip Code:80106-8928
Mailing Address - Country:US
Mailing Address - Phone:678-602-6023
Mailing Address - Fax:
Practice Address - Street 1:12655 FOREST GREEN DR
Practice Address - Street 2:
Practice Address - City:ELBERT
Practice Address - State:CO
Practice Address - Zip Code:80106-8928
Practice Address - Country:US
Practice Address - Phone:678-602-6023
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-17
Last Update Date:2024-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty