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General NPI Number Information
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NPI Number | 1245703206
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Entity Type | Organization
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Legal Business Name | AMYS ABA THERAPY SERVICES
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Dates
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Enumeration Date | 01/02/2019
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Last Update Date | 01/02/2019
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Provider Practice Location Address
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Address Line | 5250 OLD ORCHARD RD STE 300
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City | SKOKIE
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State | IL
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Zip | 60077-4462
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Country | US
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Telephone | 800-975-6164
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Fax |
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Provider Business Mailing Address
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Address Line | 6859 CHURCH ST
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City | MORTON GROVE
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State | IL
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Zip | 60053-2336
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Country | US
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Telephone | 847-763-9333
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Fax |
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Authorized Official
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Title or Position | PROGRAM DIRECTOR
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Name | SOUZAN BARKHO
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Credential |
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Telephone | 847-763-9333
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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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