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General NPI Number Information
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NPI Number | 1225550486
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Entity Type | Organization
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Legal Business Name | ABA SERVICE, LLC
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Dates
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Enumeration Date | 07/10/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 9505 INDIAN PIPE LN
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City | PROSPECT
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State | KY
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Zip | 40059-7005
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Country | US
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Telephone | 502-558-2797
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Fax | 502-371-3969
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Provider Business Mailing Address
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Address Line | 9505 INDIAN PIPE LN
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City | PROSPECT
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State | KY
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Zip | 40059-7005
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Country | US
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Telephone | 502-558-2797
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Fax | 502-371-3969
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Authorized Official
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Title or Position | BEHAVIOR ANALYST
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Name | MS. MEGAN CHRISTINE DURBIN
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Credential | BCBA. LBA
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Telephone | 502-558-2797
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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 | 168822
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License Number State | KY
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