Organization
ADVANCED BEHAVIORAL THERAPY OH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AVIGAIL KEMMOUN (CEO/ OWNER)
(848) 207-4174
Entity
Organization
Contact information
Practice address
2000 AUBURN DR STE 200, BEACHWOOD, OH 44122-4328
(848) 207-4174
Mailing address
222 DOWN HILL RUN, TOMS RIVER, NJ 08755-1021
(848) 207-4174
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
—
104100000X
Social Worker
—
—
106E00000X
Assistant Behavior Analyst
—
—
106S00000X
Behavior Technician
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
01/13/2021
Last updated
01/13/2021
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