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General NPI Number Information
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NPI Number | 1306729884
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Entity Type | Organization
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Legal Business Name | ABUNDANT ROCK, LLC
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Dates
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Enumeration Date | 07/30/2025
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Last Update Date | 07/30/2025
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Provider Practice Location Address
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Address Line | 62 WALDRON ST
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City | HILLSDALE
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State | MI
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Zip | 49242-1818
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Country | US
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Telephone | 312-505-8787
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Fax |
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Provider Business Mailing Address
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Address Line | 62 WALDRON ST
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City | HILLSDALE
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State | MI
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Zip | 49242-1818
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Country | US
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Telephone | 312-505-8787
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Fax |
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Authorized Official
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Title or Position | OWNER/INSTRUCTOR
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Name | MEGAN JULIA LASER
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Credential | MA, BCBA, RYT
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Telephone | 312-505-8787
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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