| Evolve Autism Services, LLC | |
|
111 Warwick Dr Long Beach MS 39560-2638 | |
| (228) 260-6892 | |
| (228) 567-4894 |
| Full Name | Evolve Autism Services, LLC |
|---|---|
| Speciality | Behavior Analyst |
| Location | 111 Warwick Dr, Long Beach, Mississippi |
| Authorized Official Name and Position | Ashlyn Fletcher (BCBA) |
| Authorized Official Contact | 2282606892 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Evolve Autism Services, LLC 111 Warwick Dr Long Beach MS 39560-2638 | Evolve Autism Services, LLC 111 Warwick Dr Long Beach MS 39560-2638 Ph: (228) 260-6892 |
| NPI Number | 1073293155 |
|---|---|
| Provider Enumeration Date | 07/24/2023 |
| Last Update Date | 07/24/2023 |
| Certification Date | 07/22/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073293155 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | () | Primary |
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