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General NPI Number Information
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NPI Number | 1568135093
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Entity Type | Organization
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Legal Business Name | CHANCE ABA, LLC
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Dates
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Enumeration Date | 07/30/2021
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Last Update Date | 07/30/2021
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Provider Practice Location Address
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Address Line | 22015 WILLOW SIDE CT
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City | KATY
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State | TX
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Zip | 77450-7488
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Country | US
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Telephone | 346-213-3332
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Fax |
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Provider Business Mailing Address
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Address Line | 22015 WILLOW SIDE CT
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City | KATY
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State | TX
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Zip | 77450-7488
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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 | FOUNDER
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Name | JIMIN CHEON
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Credential |
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Telephone | 346-213-6215
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TB0200X
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Taxonomy Name | Cognitive & Behavioral Psychologist
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License Number |
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License Number State |
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Taxonomy #2
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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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Taxonomy #3
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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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