Roots, Aba Therapy And Consulting Services Llc | |
6104 Old Fredericksburg Rd # 90851 Austin TX 78749-1216 | |
(512) 423-4467 | |
(512) 892-1422 |
Full Name | Roots, Aba Therapy And Consulting Services Llc |
---|---|
Speciality | Behavior Analyst |
Location | 6104 Old Fredericksburg Rd # 90851, Austin, Texas |
Authorized Official Name and Position | Stephanie Ann Etie (OWNER) |
Authorized Official Contact | 5124234467 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Roots, Aba Therapy And Consulting Services Llc 6104 Old Fredericksburg Rd # 90851 Austin TX 78749-1216 Ph: (512) 423-4467 | Roots, Aba Therapy And Consulting Services Llc 6104 Old Fredericksburg Rd # 90851 Austin TX 78749-1216 Ph: (512) 423-4467 |
NPI Number | 1740802206 |
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Provider Enumeration Date | 05/07/2020 |
Last Update Date | 01/25/2022 |
Certification Date | 01/25/2022 |
Identifier | Type | State | Issuer |
---|---|---|---|
1740802206 | NPI | - | NPPES |
4307597 | Medicaid | TX |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
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