Organization
AUTISM SERVICE PROVIDER & BEYOND, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIYA OLSON M.A. (CEO)
(630) 639-1655
Entity
Organization
Contact information
Practice address
800 W 5TH AVE, STE. 106 F/G, NAPERVILLE, IL 60563-8965
(630) 639-1655
Mailing address
800 W 5TH AVE, STE. 106 F/G, NAPERVILLE, IL 60563-8965
(630) 639-1655
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
103K00000X
Behavior Analyst
—
—
222Q00000X
Developmental Therapist
Primary
KW48321203P
IL
Other
Enumeration date
09/27/2007
Last updated
06/16/2010
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