Provider Demographics
NPI:1477129641
Name:ABA KIDS THERAPY LLC
Entity type:Organization
Organization Name:ABA KIDS THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MGR
Authorized Official - Prefix:
Authorized Official - First Name:LESTER
Authorized Official - Middle Name:
Authorized Official - Last Name:HERRERA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:239-276-2987
Mailing Address - Street 1:9857 COLONIAL WALK N
Mailing Address - Street 2:
Mailing Address - City:ESTERO
Mailing Address - State:FL
Mailing Address - Zip Code:33928-6307
Mailing Address - Country:US
Mailing Address - Phone:239-276-2987
Mailing Address - Fax:
Practice Address - Street 1:9857 COLONIAL WALK N
Practice Address - Street 2:
Practice Address - City:ESTERO
Practice Address - State:FL
Practice Address - Zip Code:33928-6307
Practice Address - Country:US
Practice Address - Phone:239-276-2987
Practice Address - Fax:855-574-0836
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-28
Last Update Date:2021-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty