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General NPI Number Information
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NPI Number | 1700434701
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Entity Type | Organization
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Legal Business Name | PIECE BY PIECE ABA THERAPY LLC
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Dates
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Enumeration Date | 09/03/2019
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Last Update Date | 09/03/2019
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Provider Practice Location Address
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Address Line | 80 PROFESSIONAL CT
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City | LAFAYETTE
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State | IN
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Zip | 47905-5152
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Country | US
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Telephone | 765-430-9828
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 3911
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City | WEST LAFAYETTE
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State | IN
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Zip | 47996-3911
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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 | CARRIE M MITCHELL
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Credential |
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Telephone | 765-430-8285
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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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Taxonomy #2
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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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