Ph Balance Behavioral

NPI #1598399115 in Longmont, Colorado

Provider Information

NPI Number: 1598399115
Entity Type: Organization
Organization Name: Ph Balance Behavioral
Primary Specialty: Behavior Analyst
Enumeration Date: Feb 24, 2020
Last Updated: Oct 4, 2023

Practice Location

Address: 954 5TH AVE
City: Longmont
State: Colorado
ZIP Code: 80501-5424
Phone: (720) 410-4529

Authorized Official

Name: DR. BRANDON ARTHUR PEREA-HICKAM, PHD, BCBA
Title: FOUNDER AND CEO
Phone: (720) 410-4529

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Psychologist - Cognitive & Behavioral — Cognitive & Behavioral	103TB0200X
Psychologist - Health Service — Health Service	103TH0100X
Assistant Behavior Analyst	106E00000X
Behavior Technician	106S00000X
Behavior Analyst	103K00000X	Primary

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