Healthcare Provider Details

I. General information

NPI: 1396261731
Provider Name (Legal Business Name): BLUE SKIES ABA, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/17/2017
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2800 SCENIC DR STE 12
BLUE RIDGE GA
30513-1402
US

IV. Provider business mailing address

2800 SCENIC DR STE 12
BLUE RIDGE GA
30513-1402
US

V. Phone/Fax

Practice location:
  • Phone: 706-946-0466
  • Fax: 888-974-1438
Mailing address:
  • Phone: 706-946-0466
  • Fax: 888-974-1438

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DEBORAH HODGDON
Title or Position: OWNER/CEO
Credential:
Phone: 571-379-0345