| NPI | 1699153700 |
|---|---|
| Former Legal Business Name | THE AUTISM GROUP |
| Entity Type | Organization |
| Authorized Contact | BROOKE WAGNER CEO 858-689-2027 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: CA 1-14-16462) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: CA 6687) |
| 235Z00000X Speech-Language Pathologist, (Licence: CA 5056) | |
| Enumeration Date | 2015-05-08 |
| Last Update Date | 2015-05-08 |