| Radiant Rising Aba Llc | |
|
2603 Tara Dr Killeen TX 76549-6114 | |
| (205) 862-1707 | |
| Not Available |
| Full Name | Radiant Rising Aba Llc |
|---|---|
| Speciality | Behavior Analyst |
| Location | 2603 Tara Dr, Killeen, Texas |
| Authorized Official Name and Position | Ashley Jalese Davis (BEHAVIOR ANALYST) |
| Authorized Official Contact | 2058621707 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Radiant Rising Aba Llc 2603 Tara Dr Killeen TX 76549-6114 Ph: (205) 862-1707 | Radiant Rising Aba Llc 2603 Tara Dr Killeen TX 76549-6114 Ph: (205) 862-1707 |
| NPI Number | 1083487227 |
|---|---|
| Provider Enumeration Date | 10/31/2023 |
| Last Update Date | 10/31/2023 |
| Certification Date | 10/31/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083487227 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
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