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NPI 1508428483

NPI 1508428483 : ABA AND PLAY LLC : SAINT CLAIR SHORES, MI

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General NPI Number Information
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    NPI Number           |    1508428483
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    Entity Type          |    Organization 
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    Legal Business Name  |    ABA AND PLAY LLC 
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Dates
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    Enumeration Date     |    07/01/2019
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    Last Update Date     |    07/01/2019
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Provider Practice Location Address
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    Address Line         |    21701 CEDAR ST 
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    City                 |    SAINT CLAIR SHORES
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    State                |    MI
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    Zip                  |    48081-2823
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    Country              |    US
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    Telephone            |    586-872-7282
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    21701 CEDAR ST 
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    City                 |    SAINT CLAIR SHORES
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    State                |    MI
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    Zip                  |    48081-2823
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    Country              |    US
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    Telephone            |    586-872-7282
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    Fax                  |    
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Authorized Official
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    Title or Position    |    CO-OWNER
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    Name                 |     JAMES  NUSE 
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    Credential           |    BCBA
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    Telephone            |    586-872-7282
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    225800000X
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    Taxonomy Name        |    Recreation Therapist
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    License Number       |    
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    License Number State |    
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Taxonomy #2
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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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