Organization
INDIVISUAL ABA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANGELA DANIELS (BEHAVIOR SPECIALIST)
(217) 317-9688
Entity
Organization
Contact information
Practice address
1984 SEDGEGRASS TRL, AURORA, IL 60504-4329
(217) 317-9688
Mailing address
1984 SEDGEGRASS TRL, AURORA, IL 60504-4329
(217) 317-9688
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/11/2013
Last updated
04/11/2013
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