Healthcare Provider Details

I. General information

NPI: 1942899265
Provider Name (Legal Business Name): ABIGAIL PAUL BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/12/2021
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1517 VANCOUVER DR
TUCKER GA
30084-8126
US

IV. Provider business mailing address

1517 VANCOUVER DR
TUCKER GA
30084-8126
US

V. Phone/Fax

Practice location:
  • Phone: 404-797-3802
  • Fax:
Mailing address:
  • Phone: 404-797-3802
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-19-92772
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberLBA002771
License Number StateGA
# 3
Primary TaxonomyN
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number0-21-13068
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: