Provider Demographics
NPI:1093475808
Name:CONNECT ABA SERVICES LLC
Entity Type:Organization
Organization Name:CONNECT ABA SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:
Authorized Official - Last Name:SHERWOOD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-402-5328
Mailing Address - Street 1:7 TONI TRL
Mailing Address - Street 2:
Mailing Address - City:FENTON
Mailing Address - State:MO
Mailing Address - Zip Code:63026-5099
Mailing Address - Country:US
Mailing Address - Phone:314-402-5328
Mailing Address - Fax:
Practice Address - Street 1:7 TONI TRL
Practice Address - Street 2:
Practice Address - City:FENTON
Practice Address - State:MO
Practice Address - Zip Code:63026-5099
Practice Address - Country:US
Practice Address - Phone:314-402-5328
Practice Address - Fax:316-666-7261
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-20
Last Update Date:2021-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency