Healthcare Provider Details

I. General information

NPI: 1487337952
Provider Name (Legal Business Name): PLAYFUL STEPS ABA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/10/2023
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 DEERFIELD RD
BOGART GA
30622-1737
US

IV. Provider business mailing address

125 DEERFIELD RD
BOGART GA
30622-1737
US

V. Phone/Fax

Practice location:
  • Phone: 770-807-9350
  • Fax:
Mailing address:
  • Phone: 770-807-9350
  • 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: ALEXANDRA HERRERA
Title or Position: FOUNDER
Credential:
Phone: 770-807-9350