Provider Demographics
NPI:1932781770
Name:ABA AUTISM SERVICES
Entity Type:Organization
Organization Name:ABA AUTISM SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRINCIPAL
Authorized Official - Prefix:
Authorized Official - First Name:DINA
Authorized Official - Middle Name:
Authorized Official - Last Name:GILLETTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-647-4134
Mailing Address - Street 1:1 WESTBROOK CORPORATE CTR STE 300
Mailing Address - Street 2:
Mailing Address - City:WESTCHESTER
Mailing Address - State:IL
Mailing Address - Zip Code:60154-5709
Mailing Address - Country:US
Mailing Address - Phone:917-647-4134
Mailing Address - Fax:
Practice Address - Street 1:1 WESTBROOK CORPORATE CTR STE 300
Practice Address - Street 2:
Practice Address - City:WESTCHESTER
Practice Address - State:IL
Practice Address - Zip Code:60154-5709
Practice Address - Country:US
Practice Address - Phone:917-647-4134
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-21
Last Update Date:2021-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty