| Aba Avenue Llc | |
|
3255 Prime Park Cir Apt 260 Kissimmee FL 34746-1879 | |
| (407) 487-0244 | |
| Not Available |
| Full Name | Aba Avenue Llc |
|---|---|
| Speciality | Behavior Analyst |
| Location | 3255 Prime Park Cir Apt 260, Kissimmee, Florida |
| Authorized Official Name and Position | Jenesha J Etienne (OWNER) |
| Authorized Official Contact | 4074870244 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Aba Avenue Llc 3255 Prime Park Cir Apt 260 Kissimmee FL 34746-1879 Ph: (407) 487-0244 | Aba Avenue Llc 3255 Prime Park Cir Apt 260 Kissimmee FL 34746-1879 Ph: (407) 487-0244 |
| NPI Number | 1508622416 |
|---|---|
| Provider Enumeration Date | 02/27/2024 |
| Last Update Date | 02/27/2024 |
| Certification Date | 02/27/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508622416 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
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