Organization
SKILLS AUTISM THERAPY HOUSE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL FONDUNGALLAH (HUMAN RESOURCES AND LEGAL MANAGER)
(651) 235-9451
Entity
Organization
Contact information
Practice address
1323 N 68TH ST, MILWAUKEE, WI 53213-2801
(651) 235-9451
Mailing address
1323 N 68TH ST, MILWAUKEE, WI 53213-2801
(651) 235-9451
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
07/05/2021
Last updated
07/05/2021
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