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General NPI Number Information
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NPI Number | 1669111639
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Entity Type | Organization
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Legal Business Name | ADAPTABLE ABA THERAPY LLC
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Dates
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Enumeration Date | 05/30/2022
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Last Update Date | 12/12/2024
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Provider Practice Location Address
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Address Line | 205 WATERWOOD BND
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City | PEACHTREE CITY
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State | GA
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Zip | 30269-1718
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Country | US
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Telephone | 323-420-9235
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Fax | 470-241-1167
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Provider Business Mailing Address
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Address Line | 312 CROSSTOWN DR # 295
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City | PEACHTREE CITY
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State | GA
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Zip | 30269-2948
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Country | US
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Telephone | 470-430-2571
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Fax | 470-241-1167
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Authorized Official
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Title or Position | BEHAVIOR ANALYST
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Name | CHRISA GAMEZ
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Credential | BCBA
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Telephone | 470-430-2571
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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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