Organization
LIGHT WAY ABA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATELYN LEGERE BCBA (OWNER)
(931) 278-2682
Entity
Organization
Contact information
Practice address
15228 E HOLLAND DR, MOUNT VERNON, IL 62864-8604
(931) 278-2682
Mailing address
15228 E HOLLAND DR, MOUNT VERNON, IL 62864-8604
(931) 278-2682
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
04/15/2024
Last updated
04/15/2024
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