Healthcare Provider Details

I. General information

NPI: 1689593097
Provider Name (Legal Business Name): GOSHEN APPLIED BEHAVIOR ANALYSIS (ABA), INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/11/2026
Last Update Date: 07/11/2026
Certification Date: 07/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5365 MEMORIAL DR
STONE MTN GA
30083-3212
US

IV. Provider business mailing address

4045 FIVE FORKS TRICKUM SW B9-270
LILBURN GA
30047
US

V. Phone/Fax

Practice location:
  • Phone: 470-819-9499
  • Fax:
Mailing address:
  • Phone: 470-819-9499
  • 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: DR. LESLIE CHARISSE PLEDGER
Title or Position: DIRECTOR
Credential:
Phone: 470-819-9499