Healthcare Provider Details

I. General information

NPI: 1487575361
Provider Name (Legal Business Name): ASTRO ABA MO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/24/2026
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

103 S JEFFERSON ST
RAYMORE MO
64083-9703
US

IV. Provider business mailing address

777 CHESTNUT RIDGE RD
CHESTNUT RIDGE NY
10977-6222
US

V. Phone/Fax

Practice location:
  • Phone: 913-667-9085
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name: ABRAHAM STIMMEL
Title or Position: DIRECTOR
Credential:
Phone: 913-667-9085