Indivisual Aba

NPI #1194168823 in Aurora, Illinois

Provider Information

NPI Number: 1194168823
Entity Type: Organization
Organization Name: Indivisual Aba
Primary Specialty: Student in an Organized Health Care Education/Training Program
Enumeration Date: Apr 11, 2013
Last Updated: Apr 11, 2013

Practice Location

Address: 1984 SEDGEGRASS TRL
City: Aurora
State: Illinois
ZIP Code: 60504-4329
Phone: (217) 317-9688

Authorized Official

Name: ANGELA DANIELS
Title: BEHAVIOR SPECIALIST
Phone: (217) 317-9688

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Student in an Organized Health Care Education/Training Program	390200000X	Primary

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