Healthcare Provider Details

I. General information

NPI: 1134869688
Provider Name (Legal Business Name): XYZABA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/31/2022
Last Update Date: 03/31/2022
Certification Date: 03/31/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1429 W PETERS COLONY RD
CARROLLTON TX
75007-2774
US

IV. Provider business mailing address

1429 W PETERS COLONY RD
CARROLLTON TX
75007-2774
US

V. Phone/Fax

Practice location:
  • Phone: 804-433-0913
  • Fax:
Mailing address:
  • Phone: 804-433-0913
  • 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: ZAHRA HAMEED ALY
Title or Position: OWNER & DIRECTOR
Credential: M.ED., BCBA, LBA
Phone: 804-433-0913