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General NPI Number Information
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NPI Number | 1588253215
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Entity Type | Organization
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Legal Business Name | OAK TREE ABA THERAPY LLC
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Dates
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Enumeration Date | 01/17/2021
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Last Update Date | 04/09/2022
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Provider Practice Location Address
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Address Line | 214 DAHLIA FALLS DR
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City | SAINT JOHNS
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State | FL
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Zip | 32259-7456
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Country | US
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Telephone | 904-446-8428
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Fax | 844-770-0422
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Provider Business Mailing Address
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Address Line | 2220 COUNTY ROAD 210 W STE 108-313
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City | JACKSONVILLE
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State | FL
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Zip | 32259-4058
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Country | US
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Telephone | 904-446-8428
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Fax | 844-770-0422
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Authorized Official
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Title or Position | FOUNDER, BCBA
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Name | MRS. TONYA MARIE WOODS
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Credential | MS
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Telephone | 904-446-8428
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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