MEDICARE: ULTIMATE ABA THERAPY LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	225XP0200X	Pediatric Occupational Therapist
2	103TC1900X	Counseling Psychologist
3	106E00000X	Assistant Behavior Analyst
4	225X00000X	Occupational Therapist
5	103T00000X	Psychologist
6	224Z00000X	Occupational Therapy Assistant
7	225100000X	Physical Therapist
8	106S00000X	Behavior Technician
9	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1801775408
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ULTIMATE ABA THERAPY LLC

Provider Business Mailing Address
First Line	:	11300 N CENTRAL EXPY STE 205
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75243-6705
Country	:	US
Telephone Number	:	214-361-3551
Fax Number	:

Provider Business Practice Location Address
First Line	:	11300 N CENTRAL EXPY STE 205
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75243-6705
Country	:	US
Telephone Number	:	214-361-3551
Fax Number	:

Authorized Official
Title or Position	:	OWNER / AUTHORIZED OFFICIAL
Name	:	ANTHONY NWAUBANI
Credential	:
Telephone Number	:	214-454-3560

Provider Enumeration Date	:	08/28/2025
Last Update Date	:	09/17/2025

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Directions to “ULTIMATE ABA THERAPY LLC ” Practice Location

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