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Organization
THE VILLAGE ABA, LLC
Active
Organization
THE VILLAGE ABA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICAH TERRELL SUTTON (PRESIDENT)
(850) 533-9156
Entity
Organization
Contact information
Practice address
133 HOSPITAL DR NE, FORT WALTON BEACH, FL 32548-5063
(850) 533-9156
(850) 347-2029
Mailing address
PO BOX 6105, NAVARRE, FL 32566-1705
(850) 533-9156
(850) 347-2029
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
106E00000X
Assistant Behavior Analyst
—
—
106S00000X
Behavior Technician
—
—
Other
Enumeration date
03/16/2023
Last updated
03/16/2023
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