Healthcare Provider Details

I. General information

NPI: 1356170195
Provider Name (Legal Business Name): STEPS BEHAVIOR SOLUTIONS ABA, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2024
Last Update Date: 07/30/2024
Certification Date: 07/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10685 PLUMMER CIR
GULFPORT MS
39503-4445
US

IV. Provider business mailing address

10685 PLUMMER CIR
GULFPORT MS
39503-4445
US

V. Phone/Fax

Practice location:
  • Phone: 985-502-8403
  • Fax:
Mailing address:
  • Phone: 985-502-8403
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateNULL

VIII. Authorized Official

Name: MS. THERESE CAMET ALLEN
Title or Position: MANAGER
Credential: MS, BCBA
Phone: 985-502-8403