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General NPI Number Information
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NPI Number | 1629753082
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Entity Type | Organization
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Legal Business Name | ALLIANCE AUTISM CENTER
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Dates
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Enumeration Date | 06/21/2023
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Last Update Date | 09/21/2023
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Provider Practice Location Address
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Address Line | 2901 MONATE CT
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City | HENDERSON
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State | NV
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Zip | 89044-1770
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Country | US
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Telephone | 734-513-2731
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Fax | 844-830-9426
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Provider Business Mailing Address
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Address Line | 3290 W BIG BEAVER RD STE 510
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City | TROY
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State | MI
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Zip | 48084-2917
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Country | US
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Telephone | 734-517-2731
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Fax | 844-830-9426
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Authorized Official
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Title or Position | CEO
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Name | MR. WILMAR R SUAN
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Credential | CPA, MST, CGMA
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Telephone | 734-513-2731
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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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