| Heale Aba, Llc | |
|
1893 Cliff Gookin Blvd Tupelo MS 38801-6558 | |
| (662) 205-0098 | |
| (662) 495-4079 |
| Full Name | Heale Aba, Llc |
|---|---|
| Speciality | Behavior Analyst |
| Location | 1893 Cliff Gookin Blvd, Tupelo, Mississippi |
| Authorized Official Name and Position | Lena Clardy (OWNER) |
| Authorized Official Contact | 6622050098 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Heale Aba, Llc Po Box 68 Tupelo MS 38802-0068 Ph: (662) 205-0098 | Heale Aba, Llc 1893 Cliff Gookin Blvd Tupelo MS 38801-6558 Ph: (662) 205-0098 |
| NPI Number | 1679311005 |
|---|---|
| Provider Enumeration Date | 07/18/2024 |
| Last Update Date | 11/01/2024 |
| Certification Date | 11/01/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679311005 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Secondary |
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
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