Healthcare Provider Details

I. General information

NPI: 1891378360
Provider Name (Legal Business Name): CMM ABA, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/03/2021
Last Update Date: 11/19/2024
Certification Date: 11/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

706 TURTLE COVE LN
VERO BEACH FL
32963-2318
US

IV. Provider business mailing address

706 TURTLE COVE LN
VERO BEACH FL
32963-2318
US

V. Phone/Fax

Practice location:
  • Phone: 772-569-5699
  • Fax: 305-290-3081
Mailing address:
  • Phone: 772-569-5699
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name: CHRISTINA MARIE MORALES
Title or Position: OWNER/BCBA
Credential:
Phone: 772-569-5699