Healthcare Provider Details

I. General information

NPI: 1407711781
Provider Name (Legal Business Name): FULL MOON FOUNDATIONS ABA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/18/2025
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

717 MAIN ST # 38
NORTH LITTLE ROCK AR
72114-4658
US

IV. Provider business mailing address

717 MAIN ST # 38
NORTH LITTLE ROCK AR
72114-4658
US

V. Phone/Fax

Practice location:
  • Phone: 501-515-4701
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name: JULIA HOWARD
Title or Position: OWNER & BCBA
Credential: BCBA, LBA, IBA
Phone: 501-515-4701