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Organization
BASELINE LOGIC LLC
Active
Organization
BASELINE LOGIC LLC
Active
Other names
Teach and Play ABA
Organization subpart
No
Provider details
NPI number
Authorized official
SARA ALLYN SHRIVASTAV BCBA (CEO)
(812) 747-9384
Entity
Organization
Contact information
Practice address
451 S PARK RIDGE RD # 102, BLOOMINGTON, IN 47401-8589
(812) 747-9384
(513) 278-5465
Mailing address
4101 E 3RD ST, BLOOMINGTON, IN 47401-5539
(812) 747-9384
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
103TB0200X
Cognitive & Behavioral Psychologist
—
—
106E00000X
Assistant Behavior Analyst
—
—
106S00000X
Behavior Technician
—
—
Other
Enumeration date
12/19/2022
Last updated
01/07/2025
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