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General NPI Number Information
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NPI Number | 1962372680
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Entity Type | Organization
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Legal Business Name | SOUTHERN OHIO APPLIED BEHAVIOR CENTER LLC
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Dates
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Enumeration Date | 11/07/2025
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Last Update Date | 11/10/2025
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Provider Practice Location Address
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Address Line | 931 BIG RUN RD
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City | PIKETON
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State | OH
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Zip | 45661-9669
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Country | US
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Telephone | 616-821-0862
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Fax | 616-821-0862
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Provider Business Mailing Address
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Address Line | 931 BIG RUN RD
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City | PIKETON
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State | OH
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Zip | 45661-9669
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Country | US
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Telephone | 616-821-0862
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Fax | 616-821-0862
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Authorized Official
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Title or Position | DIRECTOR
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Name | DAVID LEE HUTCHINS
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Credential |
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Telephone | 616-821-0862
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106E00000X
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Taxonomy Name | Assistant 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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Taxonomy #3
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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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