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General NPI Number Information
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NPI Number | 1518523745
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Entity Type | Organization
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Legal Business Name | ABA COOP
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Dates
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Enumeration Date | 05/13/2019
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Last Update Date | 01/15/2026
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Provider Practice Location Address
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Address Line | 409 S FRETZ AVE STE D
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City | EDMOND
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State | OK
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Zip | 73003-5570
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Country | US
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Telephone | 405-202-6510
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2164
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City | EDMOND
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State | OK
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Zip | 73083-2164
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | JEREMY MALWICK
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Credential | BCBA
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Telephone | 405-202-6510
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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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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