=====================================================
General NPI Number Information
=====================================================
NPI Number | 1275317141
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | AMAZING KIDS ABA
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/22/2023
-----------------------------------------------------
Last Update Date | 08/22/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1989 N 63RD ST STE 300B
-----------------------------------------------------
City | PHILADELPHIA
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 19151-2693
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 484-215-1272
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 7209 LANCASTER PIKE STE 4-1215
-----------------------------------------------------
City | HOCKESSIN
-----------------------------------------------------
State | DE
-----------------------------------------------------
Zip | 19707-9292
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 484-215-1272
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | EXEC DIRECTOR
-----------------------------------------------------
Name | MAAT AKWEI
-----------------------------------------------------
Credential | MA, LBS
-----------------------------------------------------
Telephone | 484-215-1732
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 106S00000X
-----------------------------------------------------
Taxonomy Name | Behavior Technician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 103K00000X
-----------------------------------------------------
Taxonomy Name | Behavior Analyst
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------