| Creative Aba, Llc | |
|
3720 Glenview Cir Modesto CA 95355-1309 | |
| (209) 408-9922 | |
| Not Available |
| Full Name | Creative Aba, Llc |
|---|---|
| Speciality | Behavior Analyst |
| Location | 3720 Glenview Cir, Modesto, California |
| Authorized Official Name and Position | Alexis Rose Winters (CLINICAL DIRECTOR) |
| Authorized Official Contact | 2094089992 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Creative Aba, Llc 3720 Glenview Cir Modesto CA 95355-1309 Ph: (209) 408-9922 | Creative Aba, Llc 3720 Glenview Cir Modesto CA 95355-1309 Ph: (209) 408-9922 |
| NPI Number | 1619623154 |
|---|---|
| Provider Enumeration Date | 02/23/2022 |
| Last Update Date | 02/25/2022 |
| Certification Date | 02/25/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619623154 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
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