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General NPI Number Information
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NPI Number | 1124998927
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Entity Type | Organization
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Legal Business Name | PLAYFUL MINDS ABA, LLC
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Dates
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Enumeration Date | 11/06/2025
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Last Update Date | 11/06/2025
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Provider Practice Location Address
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Address Line | 4008 S POLK ST
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City | DALLAS
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State | TX
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Zip | 75224-4925
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Country | US
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Telephone | 682-390-5316
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Fax | 945-293-2818
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Provider Business Mailing Address
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Address Line | 4008 S POLK ST
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City | DALLAS
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State | TX
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Zip | 75224-4925
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Country | US
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Telephone | 682-390-5316
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Fax | 945-293-2818
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Authorized Official
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Title or Position | CEO
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Name | MR. THESSALIAN MAEWEATHER
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Credential | BCBA, LBA
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Telephone | 682-390-5316
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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