Origins Developmental LLC

NPI #1952837346 in Fort Wayne, Indiana

Provider Information

NPI Number: 1952837346
Entity Type: Organization
Organization Name: Origins Developmental LLC
Primary Specialty: Behavior Analyst
Enumeration Date: May 4, 2017
Last Updated: May 4, 2017

Practice Location

Address: 4118 N CLINTON ST
City: Fort Wayne
State: Indiana
ZIP Code: 46805-1210
Phone: (260) 483-4988

Authorized Official

Name: JASON SHAW, MA, BCBA
Title: CHIEF OPERATING OFFICER
Phone: (260) 483-4988

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Analyst	103K00000X	Primary

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