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NPI Code Detail

MEDICARE: ABA SUCCESS

MEDICARE: ABA SUCCESS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103K00000XBehavior Analyst

General Provider Information

NPI Number : 1629730148
Entity Type Code : Organization
Provider Name (Legal Business Name) : ABA SUCCESS
Provider Business Mailing Address
First Line : 6371 SEYMOUR PL NW
Second Line :
City : ACWORTH
State : GA
Zip : 30101-8063
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 6371 SEYMOUR PL NW
Second Line :
City : ACWORTH
State : GA
Zip : 30101-8063
Country : US
Telephone Number : 770-508-0686
Fax Number :
Authorized Official
Title or Position : OWNER
Name : FLORENCE WIKLOF
Credential :
Telephone Number : 770-508-0686
Provider Enumeration Date : 10/12/2021
Last Update Date : 10/12/2021

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Directions to “ABA SUCCESS ” Practice Location

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