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General NPI Number Information
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NPI Number | 1841011301
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Entity Type | Organization
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Legal Business Name | COLORS FOR AUTISM
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Dates
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Enumeration Date | 10/17/2024
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Last Update Date | 10/17/2024
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Provider Practice Location Address
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Address Line | 139 S JACKSON ST
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City | HAWKINSVILLE
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State | GA
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Zip | 31036-4617
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Country | US
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Telephone | 478-867-9697
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Fax |
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Provider Business Mailing Address
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Address Line | 801 HIGHWAY 70 W TRLR 3
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City | ALAMOGORDO
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State | NM
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Zip | 88310-7625
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Country | US
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Telephone | 478-867-9697
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Fax |
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Authorized Official
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Title or Position | BCBA
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Name | JALIYAH CURRY
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Credential | DIRECTOR
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Telephone | 229-313-4434
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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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