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Organization
SKILLS AUTISM THERAPY HOUSE LLC
Active
Organization
SKILLS AUTISM THERAPY HOUSE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL FONDUNGALLAH (HUMAN RESOURCES AND LEGAL MANAGER)
(651) 235-9451
Entity
Organization
Contact information
Practice address
1323 N 68TH ST, MILWAUKEE, WI 53213-2801
(651) 235-9451
Mailing address
1323 N 68TH ST, MILWAUKEE, WI 53213-2801
(651) 235-9451
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
07/05/2021
Last updated
07/05/2021
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