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NPI Code Detail

MEDICARE: PRINCE ABA CONSULTING

MEDICARE: PRINCE ABA CONSULTING
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103K00000XBehavior Analyst

General Provider Information

NPI Number : 1821774605
Entity Type Code : Organization
Provider Name (Legal Business Name) : PRINCE ABA CONSULTING
Provider Business Mailing Address
First Line : 718 US HIGHWAY 82 E PMB 264
Second Line :
City : SHERMAN
State : TX
Zip : 75090
Country : US
Telephone Number : 903-821-0343
Fax Number :
Provider Business Practice Location Address
First Line : 372 BRYAN DR STE 112
Second Line :
City : DURANT
State : OK
Zip : 74701-3466
Country : US
Telephone Number : 903-444-0910
Fax Number :
Authorized Official
Title or Position : OWNER
Name : KARA STACKS
Credential : BCBA LBA
Telephone Number : 903-821-0343
Provider Enumeration Date : 06/26/2023
Last Update Date : 05/12/2024

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Directions to “PRINCE ABA CONSULTING ” Practice Location

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