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General NPI Number Information
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NPI Number | 1194340968
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Entity Type | Organization
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Legal Business Name | LUX ABA LLC
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Dates
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Enumeration Date | 06/08/2020
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Last Update Date | 06/23/2022
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Provider Practice Location Address
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Address Line | 18443 SW 87TH PL
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City | CUTLER BAY
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State | FL
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Zip | 33157-7268
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Country | US
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Telephone | 305-699-3241
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Fax |
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Provider Business Mailing Address
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Address Line | 18443 SW 87TH PL
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City | CUTLER BAY
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State | FL
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Zip | 33157-7268
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Country | US
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Telephone | 305-699-3241
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Fax |
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Authorized Official
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Title or Position | BCBA/ PRESIDENT
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Name | HENDRIK F KROES
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Credential | BCBA
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Telephone | 305-699-3241
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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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