Healthcare Provider Details

I. General information

NPI: 1033772082
Provider Name (Legal Business Name): APPLIED BEHAVIORAL CONNECTIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/16/2019
Last Update Date: 02/27/2023
Certification Date: 02/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3720 DRESSLER RD NW
CANTON OH
44718-2700
US

IV. Provider business mailing address

3720 DRESSLER RD NW
CANTON OH
44718-2700
US

V. Phone/Fax

Practice location:
  • Phone: 330-309-3133
  • Fax:
Mailing address:
  • Phone: 330-309-3133
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name: VANESSA FESSENDEN
Title or Position: CLINICAL DIRECTOR
Credential: BCBA-D
Phone: 330-309-3133