Healthcare Provider Details
I. General information
NPI: 1649132465
Provider Name (Legal Business Name): ABOVE AND BEYOND ABA AZ LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/01/2025
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1846 E INNOVATION PARK DR STE 100
ORO VALLEY AZ
85755-1963
US
IV. Provider business mailing address
1846 E INNOVATION PARK DR STE 100
ORO VALLEY AZ
85755-1963
US
V. Phone/Fax
- Phone: 520-277-3996
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103K00000X |
| Taxonomy | Behavior Analyst |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 106S00000X |
| Taxonomy | Behavior Technician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MATT
ROKOWSKY
Title or Position: MANAGER
Credential:
Phone: 520-277-3996