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General NPI Number Information
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NPI Number | 1356261960
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Entity Type | Organization
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Legal Business Name | LITTLE WAVES ABA LLC
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Dates
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Enumeration Date | 07/16/2026
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Last Update Date | 07/16/2026
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Provider Practice Location Address
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Address Line | 134 DEER LAKE CIR
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City | ORMOND BEACH
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State | FL
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Zip | 32174-4275
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Country | US
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Telephone | 774-243-4145
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Fax |
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Provider Business Mailing Address
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Address Line | 134 DEER LAKE CIR
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City | ORMOND BEACH
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State | FL
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Zip | 32174-4275
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Country | US
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Telephone | 774-243-4145
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Fax |
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Authorized Official
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Title or Position | CEO/ LEAD ANALYST
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Name | RIAN KUBANNEK
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Credential | MS, BCBA
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Telephone | 774-243-4145
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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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