Healthcare Provider Details

I. General information

NPI: 1366120610
Provider Name (Legal Business Name): ABSOLUTE AUTISM THERAPY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2023
Last Update Date: 05/14/2025
Certification Date: 05/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6801 JEFFERSON ST NE STE 150 PMB 3332
ALBUQUERQUE NM
87109
US

IV. Provider business mailing address

6801 JEFFERSON ST NE STE 150 PMB 3332
ALBUQUERQUE NM
87109
US

V. Phone/Fax

Practice location:
  • Phone: 505-605-6572
  • Fax: 505-944-1927
Mailing address:
  • Phone: 505-605-6572
  • Fax: 505-944-1927

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: KATRINA EVA GITTINS
Title or Position: CEO
Credential: LBA
Phone: 505-738-5906