Provider Demographics
NPI:1083421655
Name:GROWING MINDS ABA THERAPY PLLC
Entity type:Organization
Organization Name:GROWING MINDS ABA THERAPY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:SHELBY
Authorized Official - Middle Name:
Authorized Official - Last Name:KAUMP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-910-3397
Mailing Address - Street 1:36216 FREEDOM RD UNIT 137
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48335-3002
Mailing Address - Country:US
Mailing Address - Phone:248-257-3881
Mailing Address - Fax:
Practice Address - Street 1:36216 FREEDOM RD UNIT 137
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48335-3002
Practice Address - Country:US
Practice Address - Phone:248-257-3881
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-16
Last Update Date:2024-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty