Full Spectrum Aba Of Mississippi LLC
Behavior Analyst in Ridgeland, MS. Organization (NPI-2).
NPI number1164066924
StatusActive
Last updated in NPPESMar 4, 2020
Details
- NPI
- 1164066924
- Entity type
- Organization (NPI-2)
- Legal business name
- Full Spectrum Aba Of Mississippi LLC
- Organization subpart
- No
- Enumeration date
- Nov 4, 2019
- Certification date
- Mar 4, 2020
- Last updated
- Mar 4, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 103K00000X | Behavior Analyst | – | – | Yes |
| 106E00000X | Assistant Behavior Analyst | – | – | |
| 106S00000X | Behavior Technician | – | – |
Practice location
270 Trace Colony Park Dr Ste BRidgeland, MS 39157-8810
Phone 813-926-5454
Mailing address
270 Trace Colony Park Dr Ste BRidgeland, MS 39157-8810
Authorized official
Collin Edward Streetman
Owner
8139265454
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