Most Relevant Information
Provider Data
| NPI Number: | 1003402827 |
| Provider Name: | CASEY SURBLIS M. ED., BCBA |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: | RBT-20-148388 |
Most Important Dates
| Enumeration Date: | 12/16/2020 |
| Last Updated: | 05/18/2023 |
Provider Practice Location
805 E WASHINGTON ST STE 130
MEDINA
OH
442563331
Practice Location Phone/Fax
| Phone: | 2342558531 |
| Fax: |
Provider Mailing Location
805 E WASHINGTON ST STE 130
MEDINA
OH
442563331
Provider Mailing Phone/Fax
| Phone: | 2342558531 |
| Fax: |