| Grace Aba, Llc | |
|
315 Ashford Cir Lagrange GA 30240-8895 | |
| (209) 430-1887 | |
| Not Available |
| Full Name | Grace Aba, Llc |
|---|---|
| Speciality | Behavior Analyst |
| Location | 315 Ashford Cir, Lagrange, Georgia |
| Authorized Official Name and Position | Cassandra Bailey (OWNER & CEO) |
| Authorized Official Contact | 2094301887 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Grace Aba, Llc 315 Ashford Cir Lagrange GA 30240-8895 Ph: (209) 430-1887 | Grace Aba, Llc 315 Ashford Cir Lagrange GA 30240-8895 Ph: (209) 430-1887 |
| NPI Number | 1225855133 |
|---|---|
| Provider Enumeration Date | 09/23/2024 |
| Last Update Date | 09/23/2024 |
| Certification Date | 09/23/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225855133 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
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