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General NPI Number Information
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NPI Number | 1649776592
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Entity Type | Organization
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Legal Business Name | NEW DAY ABA THERAPY LLC
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Dates
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Enumeration Date | 03/31/2018
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Last Update Date | 06/30/2019
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Provider Practice Location Address
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Address Line | 2450 ATLANTA HWY STE 902
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City | CUMMING
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State | GA
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Zip | 30040-1252
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Country | US
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Telephone | 770-282-7676
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Fax | 833-255-5667
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Provider Business Mailing Address
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Address Line | 2450 ATLANTA HWY STE 902
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City | CUMMING
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State | GA
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Zip | 30040-1252
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Country | US
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Telephone | 770-282-7676
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Fax | 833-255-5667
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Authorized Official
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Title or Position | BILLING MANAGER
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Name | ANGIE BOLTWOOD
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Credential |
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Telephone | 770-530-9051
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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 | 1052189
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License Number State | GA
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