| Supersonic Aba Llc | |
|
22600 Ascoa Ct Strongsville OH 44149-4700 | |
| (216) 260-4847 | |
| Not Available |
| Full Name | Supersonic Aba Llc |
|---|---|
| Speciality | Behavior Analyst |
| Location | 22600 Ascoa Ct, Strongsville, Ohio |
| Authorized Official Name and Position | Susan Som (CEO/CLINICAL DIRECTOR) |
| Authorized Official Contact | 3172259119 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Supersonic Aba Llc 22600 Ascoa Ct Strongsville OH 44149-4700 Ph: (216) 260-4847 | Supersonic Aba Llc 22600 Ascoa Ct Strongsville OH 44149-4700 Ph: (216) 260-4847 |
| NPI Number | 1144938564 |
|---|---|
| Provider Enumeration Date | 11/15/2022 |
| Last Update Date | 03/23/2023 |
| Certification Date | 03/23/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144938564 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
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