| NPI | 1619211042 |
|---|---|
| Former Legal Business Name | SL START & ASSOCIATES, LLC |
| Entity Type | Organization |
| Authorized Contact | HEIDI MORAGO Credentialing Specialist 920-857-9041 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| 103TC0700X Psychologist, Clinical | |
| Enumeration Date | 2012-11-26 |
| Last Update Date | 2021-06-10 |