Organization
ABA FAMILY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHANNON KIESS M.ED., BCBA (OWNER)
(772) 530-0575
Entity
Organization
Contact information
Practice address
2074 SE DOVERBROOK ST, PORT SAINT LUCIE, FL 34983-4698
(772) 905-8836
Mailing address
2074 SE DOVERBROOK ST, PORT SAINT LUCIE, FL 34983-4698
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
11623919
FL
Other
Enumeration date
01/31/2018
Last updated
01/31/2018
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