Organization · NPI-2

Autism Behavior Support, LLC

Behavior Analyst · Killeen, TX

NPI number1083244958
StatusActive
Last updated in NPPESJul 20, 2020

Details

NPI
1083244958
Entity type
Organization (NPI-2)
Legal business name
Autism Behavior Support, LLC
Organization subpart
No
Enumeration date
Jan 20, 2020
Certification date
Jul 20, 2020
Last updated
Jul 20, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
103K00000X Behavior Analyst––Yes
106S00000X Behavior Technician––

Other names

  • Mary Ayala (Doing Business As)

Practice location

4003 W Stan Schlueter Loop Ste 3
Killeen, TX 76549-6120

Phone 719-352-2970 · Fax 254-267-1091

Mailing address

5212 Allegany Dr
Killeen, TX 76549-5648

Phone 719-352-2970

Authorized official

Mary C Ayala
Owner
7193522970

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