Organization
PROACTIVE BEHAVIOR THERAPY, LLC
Active
Other names
Proactive Behavior Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LEAH CHRISTINE GONGOLA PHD, BCBA-D, COBA (DIRECTOR)
(440) 313-8636
Entity
Organization
Contact information
Practice address
12573 CHILLICOTHE RD, CHESTERLAND, OH 44026-2536
(440) 201-9181
(855) 960-0149
Mailing address
12573 CHILLICOTHE RD, CHESTERLAND, OH 44026-2536
(440) 201-9181
(855) 960-0149
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
261Q00000X
Clinic/Center
—
—
Other
Enumeration date
09/20/2019
Last updated
10/02/2024
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