Healthcare Provider Details

I. General information

NPI: 1497214365
Provider Name (Legal Business Name): AUTISM COMPLETE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/19/2019
Last Update Date: 10/14/2025
Certification Date: 10/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

114 W CAMPBELLTON ST
FAIRBURN GA
30213-1219
US

IV. Provider business mailing address

114 W CAMPBELLTON ST
FAIRBURN GA
30213-1219
US

V. Phone/Fax

Practice location:
  • Phone: 770-742-0249
  • Fax: 470-460-8989
Mailing address:
  • Phone: 770-742-0249
  • Fax: 470-460-8989

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: BARJONA AZERENE ANDREWS
Title or Position: OWNER, CLINIC DIRECTOR
Credential: BCBA
Phone: 770-742-0249