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General NPI Number Information
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NPI Number | 1679311005
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Entity Type | Organization
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Legal Business Name | HEALE ABA, LLC
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Dates
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Enumeration Date | 07/18/2024
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Last Update Date | 04/14/2025
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Provider Practice Location Address
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Address Line | 1893 CLIFF GOOKIN BLVD
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City | TUPELO
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State | MS
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Zip | 38801-6558
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Country | US
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Telephone | 662-205-0098
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Fax | 662-495-4079
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Provider Business Mailing Address
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Address Line | 143C WILLOWBROOK DR
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City | SALTILLO
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State | MS
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Zip | 38866-6896
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Country | US
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Telephone | 662-205-0098
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Fax | 662-495-4079
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Authorized Official
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Title or Position | SENIOR DIRECTOR
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Name | WILLIAM KLEIN
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Credential |
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Telephone | 662-205-0655
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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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 | 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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