| Proactive Behavior Therapy | |
|
12573 Chillicothe Road Chesterland OH 44026 | |
| (440) 313-8636 | |
| (855) 960-0149 |
| Full Name | Proactive Behavior Therapy |
|---|---|
| Speciality | Behavior Technician |
| Location | 12573 Chillicothe Road, Chesterland, Ohio |
| Authorized Official Name and Position | Leah Christine Gongola (FOUNDER AND CEO) |
| Authorized Official Contact | 4403138636 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Proactive Behavior Therapy 12573 Chillicothe Road Chesterland OH 44026 Ph: (440) 313-8636 | Proactive Behavior Therapy 12573 Chillicothe Road Chesterland OH 44026 Ph: (440) 313-8636 |
| NPI Number | 1912686197 |
|---|---|
| Provider Enumeration Date | 07/14/2023 |
| Last Update Date | 07/14/2023 |
| Certification Date | 07/14/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912686197 | NPI | - | NPPES |
| 0477305 | Medicaid | OH |
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