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General NPI Number Information
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NPI Number | 1679408348
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Entity Type | Organization
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Legal Business Name | MEM ABA SERVICES LLC
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Dates
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Enumeration Date | 06/15/2026
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Last Update Date | 06/15/2026
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Provider Practice Location Address
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Address Line | 8095 CLUB PKWY BLDG 6
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City | CORDOVA
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State | TN
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Zip | 38016-5976
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Country | US
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Telephone | 901-264-9595
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Fax | 901-328-5618
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Provider Business Mailing Address
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Address Line | 8095 CLUB PKWY BLDG 6
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City | CORDOVA
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State | TN
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Zip | 38016-5976
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Country | US
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Telephone | 901-264-9595
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Fax | 901-328-5618
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Authorized Official
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Title or Position | CFO
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Name | ROMAN SHULOV
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Credential |
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Telephone | 901-264-9595
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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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