# INDIVISUAL ABA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1194168823
- **Authorized official:** ANGELA DANIELS (BEHAVIOR SPECIALIST)
- **Authorized official phone:** (217) 317-9688

## Contact information

- **Practice address:** 1984 SEDGEGRASS TRL, AURORA, IL 60504-4329
- **Practice address phone:** (217) 317-9688
- **Mailing address:** 1984 SEDGEGRASS TRL, AURORA, IL 60504-4329
- **Mailing address phone:** (217) 317-9688

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 390200000X | Student in an Organized Health Care Education/Training Program | — | NULL | Yes |
| 390200000X | Student in an Organized Health Care Education/Training Program | — | — | Yes |

## Other

- **Enumeration date:** 04/11/2013
- **Last updated:** 04/11/2013