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General NPI Number Information
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NPI Number | 1669201349
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Entity Type | Organization
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Legal Business Name | AIRBORNE ABA LLC
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Dates
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Enumeration Date | 07/30/2024
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Last Update Date | 10/09/2024
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Provider Practice Location Address
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Address Line | 445 MINNESOTA ST STE 1500
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City | SAINT PAUL
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State | MN
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Zip | 55101-2269
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Country | US
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Telephone | 612-451-9897
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Fax |
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Provider Business Mailing Address
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Address Line | 2506 LAURELHURST RD
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City | UNIVERSITY HEIGHTS
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State | OH
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Zip | 44118-4612
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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 | OWNER
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Name | DAVID BRODY
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Credential |
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Telephone | 347-786-2005
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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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