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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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