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NPI Code Detail

MEDICARE: MISS ALLIA OGDEN BCABA

MEDICARE:  MISS ALLIA  OGDEN  BCABA
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
1106E00000XAssistant Behavior Analyst0-19-10242IL

General Provider Information

NPI Number : 1760742191
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS ALLIA OGDEN BCABA
Provider Business Mailing Address
First Line : 3915 W AINSLIE ST APT 2
Second Line :
City : CHICAGO
State : IL
Zip : 60625-6155
Country : US
Telephone Number : 312-823-5912
Fax Number :
Provider Business Practice Location Address
First Line : 3915 W AINSLIE ST
Second Line :
City : CHICAGO
State : IL
Zip : 60625-6155
Country : US
Telephone Number : 312-823-5912
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/18/2012
Last Update Date : 06/24/2020

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Directions to “ MISS ALLIA OGDEN BCABA” Practice Location

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