| I-aba | |
|
3211 Grant Line Rd Suite 15 New Albany IN 47150-2175 | |
| (502) 417-9830 | |
| Not Available |
| Full Name | I-aba |
|---|---|
| Speciality | Behavior Analyst |
| Location | 3211 Grant Line Rd, New Albany, Indiana |
| Authorized Official Name and Position | Keith Hersh (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 5024179830 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| I-aba 11305 Arbor Wood Dr Louisville KY 40299-4189 Ph: (502) 417-9830 | I-aba 3211 Grant Line Rd Suite 15 New Albany IN 47150-2175 Ph: (502) 417-9830 |
| NPI Number | 1205105467 |
|---|---|
| Provider Enumeration Date | 12/17/2011 |
| Last Update Date | 08/15/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205105467 | NPI | - | NPPES |
| 1-04-2095 | Other | KY | BOARD CERTIFIED BEHAVIOR ANALYST |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | 1-04-2095 (Kentucky) | Primary |
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