Organization
AVENUES FOR AUTISM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALEXIS M EGGENBERGER LISW-S, BCBA (DIRECTOR)
(419) 704-3408
Entity
Organization
Contact information
Practice address
2105 LAWRENCE AVE STE 232, TOLEDO, OH 43606-4822
(419) 291-7031
Mailing address
2105 LAWRENCE AVE STE 232, TOLEDO, OH 43606-4822
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
—
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1518250950
—
OH
Enumeration date
04/20/2022
Last updated
06/20/2022
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