MEDICARE: SLT ABA THERAPY CORP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1225816176
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SLT ABA THERAPY CORP

Provider Business Mailing Address
First Line	:	5006 TROUBLE CREEK RD STE 229
Second Line	:
City	:	NEW PORT RICHEY
State	:	FL
Zip	:	34652-4922
Country	:	US
Telephone Number	:	786-728-1845
Fax Number	:

Provider Business Practice Location Address
First Line	:	5006 TROUBLE CREEK RD STE 229
Second Line	:
City	:	NEW PORT RICHEY
State	:	FL
Zip	:	34652-4922
Country	:	US
Telephone Number	:	786-728-1845
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	YANISEL VENTO
Credential	:
Telephone Number	:	786-728-1845

Provider Enumeration Date	:	09/20/2023
Last Update Date	:	09/20/2023

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Directions to “SLT ABA THERAPY CORP ” Practice Location

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