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General NPI Number Information
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NPI Number | 1093261653
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Entity Type | Organization
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Legal Business Name | CHILDFIRST BEHAVIOR THERAPY, LLC
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Dates
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Enumeration Date | 09/01/2016
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Last Update Date | 09/01/2016
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Provider Practice Location Address
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Address Line | 705 N MART CT
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City | PALATINE
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State | IL
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Zip | 60067
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Country | US
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Telephone | 847-322-8452
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Fax |
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Provider Business Mailing Address
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Address Line | 705 N MART CT
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City | PALATINE
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State | IL
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Zip | 60067
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Country | US
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Telephone | 847-322-8452
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Fax |
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Authorized Official
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Title or Position | BCBA-BUSINESS OWNER
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Name | MRS. ASHLEY D MUSIAL
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Credential | M.ED, BCBA
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Telephone | 847-322-8452
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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