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General NPI Number Information
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NPI Number | 1477005379
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Entity Type | Organization
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Legal Business Name | AHIO INCORPORATED
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Dates
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Enumeration Date | 10/26/2016
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Last Update Date | 03/29/2017
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Provider Practice Location Address
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Address Line | 5740 36TH LN
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City | VERO BEACH
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State | FL
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Zip | 32966-1870
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Country | US
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Telephone | 772-257-9817
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Fax |
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Provider Business Mailing Address
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Address Line | 5740 36TH LN
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City | VERO BEACH
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State | FL
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Zip | 32966-1870
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Country | US
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Telephone | 772-257-9817
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | ASHLEIGH DOMINGUEZ
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Credential |
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Telephone | 772-257-9817
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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 | 1-16-21334
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number | 16-14411
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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