Healthcare Provider Details

I. General information

NPI: 1750276283
Provider Name (Legal Business Name): SUNNY SKIES ABA GA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/12/2025
Last Update Date: 06/12/2025
Certification Date: 06/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1640 POWERS FERRY RD SE STE 324
MARIETTA GA
30067-5491
US

IV. Provider business mailing address

4403 15TH AVE STE 115
BROOKLYN NY
11219-1604
US

V. Phone/Fax

Practice location:
  • Phone: 404-410-0555
  • 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
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name: MIRY DEMBICER
Title or Position: CEO
Credential:
Phone: 919-502-1112