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General NPI Number Information
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NPI Number | 1912662479
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Entity Type | Organization
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Legal Business Name | ABA GOLDEN STEPS MN LLC
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Dates
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Enumeration Date | 11/01/2021
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Last Update Date | 11/01/2021
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Provider Practice Location Address
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Address Line | 2355 HIGHWAY 36 W STE 400
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City | ROSEVILLE
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State | MN
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Zip | 55113-3905
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Country | US
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Telephone | 828-351-4466
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Fax |
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Provider Business Mailing Address
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Address Line | 560 SYLVAN AVE STE 1110
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City | ENGLEWOOD CLIFFS
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State | NJ
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Zip | 07632-3118
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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 | CEO
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Name | YISROEL WOLMARK
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Credential |
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Telephone | 845-596-5130
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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Taxonomy #2
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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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