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General NPI Number Information
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NPI Number | 1083421655
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Entity Type | Organization
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Legal Business Name | GROWING MINDS ABA THERAPY PLLC
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Dates
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Enumeration Date | 12/16/2024
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Last Update Date | 12/16/2024
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Provider Practice Location Address
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Address Line | 36216 FREEDOM RD UNIT 137
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City | FARMINGTON HILLS
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State | MI
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Zip | 48335-3002
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Country | US
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Telephone | 248-257-3881
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Fax |
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Provider Business Mailing Address
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Address Line | 36216 FREEDOM RD UNIT 137
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City | FARMINGTON HILLS
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State | MI
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Zip | 48335-3002
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Country | US
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Telephone | 248-257-3881
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Fax |
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Authorized Official
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Title or Position | OWNER/CEO
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Name | SHELBY KAUMP
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Credential |
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Telephone | 248-910-3397
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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