| Time To Shine Aba Llc | |
|
21 Boulder Hill Pass Montgomery IL 60538-1911 | |
| (630) 331-3667 | |
| Not Available |
| Full Name | Time To Shine Aba Llc |
|---|---|
| Speciality | Behavior Analyst |
| Location | 21 Boulder Hill Pass, Montgomery, Illinois |
| Authorized Official Name and Position | Caitlyn Wysoglad (BCBA) |
| Authorized Official Contact | 6307793029 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Time To Shine Aba Llc 21 Boulder Hill Pass Montgomery IL 60538-1911 Ph: (630) 331-3667 | Time To Shine Aba Llc 21 Boulder Hill Pass Montgomery IL 60538-1911 Ph: (630) 331-3667 |
| NPI Number | 1649983032 |
|---|---|
| Provider Enumeration Date | 12/30/2022 |
| Last Update Date | 09/10/2024 |
| Certification Date | 09/10/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649983032 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
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