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General NPI Number Information
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NPI Number | 1992340756
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Entity Type | Organization
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Legal Business Name | ABA ATLANTA LLC
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Dates
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Enumeration Date | 11/15/2019
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Last Update Date | 11/15/2019
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Provider Practice Location Address
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Address Line | 260 PEACHTREE ST NW STE 2200
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City | ATLANTA
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State | GA
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Zip | 30303-1292
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Country | US
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Telephone | 239-249-1840
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Fax |
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Provider Business Mailing Address
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Address Line | 11983 TAMIAMI TRL N # 121
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City | NAPLES
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State | FL
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Zip | 34110-1603
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OPERATIONS
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Name | WIL GLASER
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Credential |
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Telephone | 239-249-1840
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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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