Organization
BASELINE LOGIC LLC
Active
Other names
Teach and Play ABA
Organization subpart
No
Provider details
NPI number
Authorized official
SARA ALLYN SHRIVASTAV BCBA (CEO)
(812) 747-9384
Entity
Organization
Contact information
Practice address
451 S PARK RIDGE RD # 102, BLOOMINGTON, IN 47401-8589
(812) 747-9384
(513) 278-5465
Mailing address
4101 E 3RD ST, BLOOMINGTON, IN 47401-5539
(812) 747-9384
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
103TB0200X
Cognitive & Behavioral Psychologist
—
—
106E00000X
Assistant Behavior Analyst
—
—
106S00000X
Behavior Technician
—
—
Other
Enumeration date
12/19/2022
Last updated
01/07/2025
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