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General NPI Number Information
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NPI Number | 1972125672
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Entity Type | Organization
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Legal Business Name | ABSOLUTE BEHAVIOR ADVANCEMENT
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Dates
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Enumeration Date | 05/15/2020
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Last Update Date | 05/15/2020
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Provider Practice Location Address
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Address Line | 23018 SANDPIPER TRL
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City | SPRING
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State | TX
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Zip | 77373-5405
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Country | US
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Telephone | 803-257-4637
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Fax |
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Provider Business Mailing Address
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Address Line | 23018 SANDPIPER TRL
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City | SPRING
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State | TX
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Zip | 77373-5405
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Country | US
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Telephone | 803-257-4637
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Fax |
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Authorized Official
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Title or Position | BCBA
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Name | MISS LADELRIE SHANIKA HALL
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Credential | BCBA. LBA
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Telephone | 803-257-4637
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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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