Provider Demographics
NPI:1578041372
Name:OPIYO, AUBREE
Entity Type:Individual
Prefix:
First Name:AUBREE
Middle Name:
Last Name:OPIYO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:AUBREE
Other - Middle Name:
Other - Last Name:BOWEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BCBA, COBA
Mailing Address - Street 1:4187 ROCHESTER CIR APT C
Mailing Address - Street 2:
Mailing Address - City:SPRINGDALE
Mailing Address - State:AR
Mailing Address - Zip Code:72764-7578
Mailing Address - Country:US
Mailing Address - Phone:765-914-5465
Mailing Address - Fax:
Practice Address - Street 1:6830 COCHRAN RD
Practice Address - Street 2:
Practice Address - City:SOLON
Practice Address - State:OH
Practice Address - Zip Code:44139-3966
Practice Address - Country:US
Practice Address - Phone:216-282-1234
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-02
Last Update Date:2022-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106S00000X
1-21-52042103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician