Organization
SUNRISE ABA OF WISCONSIN, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRADY KEITH (CEO)
(628) 250-7500
Entity
Organization
Contact information
Practice address
6580 MONONA DR # 1173, MONONA, WI 53716-4032
(628) 250-7500
Mailing address
505 SAN MARIN DR STE 100B, NOVATO, CA 94945-1309
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
03/03/2023
Last updated
03/03/2023
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