=====================================================
General NPI Number Information
=====================================================
NPI Number | 1992668206
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ABA GROUP
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/03/2025
-----------------------------------------------------
Last Update Date | 12/03/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3652 CALICO COVE CT
-----------------------------------------------------
City | LAS VEGAS
-----------------------------------------------------
State | NV
-----------------------------------------------------
Zip | 89147-6801
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 315-256-6138
-----------------------------------------------------
Fax | 702-430-7660
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3652 CALICO COVE CT
-----------------------------------------------------
City | LAS VEGAS
-----------------------------------------------------
State | NV
-----------------------------------------------------
Zip | 89147-6801
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 315-256-6138
-----------------------------------------------------
Fax | 702-430-7660
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MR
-----------------------------------------------------
Name | MR. MATTHEW LEHMAN
-----------------------------------------------------
Credential | LBA
-----------------------------------------------------
Telephone | 315-256-6138
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 235Z00000X
-----------------------------------------------------
Taxonomy Name | Speech-Language Pathologist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------