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General NPI Number Information
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NPI Number | 1346844651
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Entity Type | Organization
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Legal Business Name | AUTISMNESS ABA LLC
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Dates
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Enumeration Date | 11/27/2020
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Last Update Date | 11/27/2020
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Provider Practice Location Address
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Address Line | 614 W CROSSVILLE RD
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City | ROSWELL
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State | GA
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Zip | 30075-2560
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Country | US
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Telephone | 770-680-2535
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Fax |
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Provider Business Mailing Address
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Address Line | 2231 SAGE MOUNTAIN CT SW
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City | MARIETTA
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State | GA
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Zip | 30064-2204
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ANGELA ERISMAN
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Credential |
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Telephone | 813-468-7750
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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