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General NPI Number Information
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NPI Number | 1831589878
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Entity Type | Organization
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Legal Business Name | BEYOND ABA, LLC
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Dates
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Enumeration Date | 01/29/2015
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Last Update Date | 06/25/2020
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Provider Practice Location Address
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Address Line | 6222 94TH AVE
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City | KENOSHA
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State | WI
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Zip | 53142-8233
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Country | US
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Telephone | 262-496-8735
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Fax | 262-997-1121
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Provider Business Mailing Address
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Address Line | 6222 94TH AVE
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City | KENOSHA
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State | WI
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Zip | 53142-8233
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Country | US
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Telephone | 262-496-8735
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Fax | 262-997-1121
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Authorized Official
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Title or Position | OWNER
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Name | MS. CHARLEEN M GEISSMAN
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Credential | MS
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Telephone | 262-496-8735
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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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