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 |
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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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