| Nova Aba Llc. | |
|
4797 West Grande Market Dr. Appleton WI 54913 | |
| (920) 815-3873 | |
| (833) 216-6563 |
| Full Name | Nova Aba Llc. |
|---|---|
| Speciality | Behavior Analyst |
| Location | 4797 West Grande Market Dr., Appleton, Wisconsin |
| Authorized Official Name and Position | Emily Jo Paschen (OWNER) |
| Authorized Official Contact | 9202573496 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Nova Aba Llc. 4797 West Grande Market Dr. Appleton WI 54913 Ph: (920) 815-3873 | Nova Aba Llc. 4797 West Grande Market Dr. Appleton WI 54913 Ph: (920) 815-3873 |
| NPI Number | 1245987478 |
|---|---|
| Provider Enumeration Date | 03/08/2022 |
| Last Update Date | 03/08/2022 |
| Certification Date | 03/08/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245987478 | NPI | - | NPPES |
| 100049443 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
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