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NPI 1124816715

NPI 1124816715 : INCLUSIVE ABA AZ LLC : SCOTTSDALE, AZ

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General NPI Number Information
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    NPI Number           |    1124816715
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    Entity Type          |    Organization 
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    Legal Business Name  |    INCLUSIVE ABA AZ LLC 
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Dates
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    Enumeration Date     |    04/25/2025
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    Last Update Date     |    04/25/2025
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Provider Practice Location Address
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    Address Line         |    3260 N HAYDEN RD STE 210 
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    City                 |    SCOTTSDALE
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    State                |    AZ
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    Zip                  |    85251-6651
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    Country              |    US
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    Telephone            |    303-616-1188
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    1525 PROSPECT ST STE 603 
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    City                 |    LAKEWOOD
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    State                |    NJ
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    Zip                  |    08701-4642
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    Country              |    US
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    Telephone            |    
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    Fax                  |    
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Authorized Official
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    Title or Position    |    VP OF OPERATIONS
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    Name                 |     JUDY  MILLER 
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    Credential           |    
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    Telephone            |    303-616-1188
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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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