| Performance Aba Therapy Llc | |
|
2131 Stallings St Nw # 2832 Covington GA 30014-2351 | |
| (770) 895-2978 | |
| Not Available |
| Full Name | Performance Aba Therapy Llc |
|---|---|
| Speciality | Behavior Analyst |
| Location | 2131 Stallings St Nw # 2832, Covington, Georgia |
| Authorized Official Name and Position | Ebony Powell (OWNER) |
| Authorized Official Contact | 7708952978 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Performance Aba Therapy Llc 2131 Stallings St Nw # 2832 Covington GA 30014-2351 Ph: (770) 895-2978 | Performance Aba Therapy Llc 2131 Stallings St Nw # 2832 Covington GA 30014-2351 Ph: (770) 895-2978 |
| NPI Number | 1407533003 |
|---|---|
| Provider Enumeration Date | 07/05/2023 |
| Last Update Date | 07/05/2023 |
| Certification Date | 07/05/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407533003 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
| 106S00000X | Behavior Technician | (* (Not Available)) | Secondary |
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