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General NPI Number Information
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NPI Number | 1518838762
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Entity Type | Organization
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Legal Business Name | AVION ABA MO LLC
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Dates
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Enumeration Date | 09/12/2025
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Last Update Date | 09/12/2025
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Provider Practice Location Address
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Address Line | 4625 LINDELL BLVD STE 200
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City | SAINT LOUIS
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State | MO
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Zip | 63108-3725
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Country | US
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Telephone | 385-527-7500
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Fax | 385-527-7501
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Provider Business Mailing Address
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Address Line | 4625 LINDELL BLVD STE 200
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City | SAINT LOUIS
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State | MO
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Zip | 63108-3725
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Country | US
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Telephone | 385-527-7500
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Fax | 385-527-7501
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Authorized Official
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Title or Position | DIRECTOR
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Name | SHALOM GELLIS
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Credential |
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Telephone | 385-527-7500
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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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