Shining Light Aba Llc | |
171 Vz County Road 4114 Canton TX 75103-5651 | |
(903) 368-3741 | |
(888) 518-6656 |
Full Name | Shining Light Aba Llc |
---|---|
Speciality | Behavior Analyst |
Location | 171 Vz County Road 4114, Canton, Texas |
Authorized Official Name and Position | Carrie Michelle Bass (BCBA/SUPERVISOR) |
Authorized Official Contact | 9035704545 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Shining Light Aba Llc 171 Vz County Road 4114 Canton TX 75103-5651 Ph: (903) 368-3741 | Shining Light Aba Llc 171 Vz County Road 4114 Canton TX 75103-5651 Ph: (903) 368-3741 |
NPI Number | 1235968751 |
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Provider Enumeration Date | 08/01/2024 |
Last Update Date | 08/01/2024 |
Certification Date | 08/01/2024 |
Identifier | Type | State | Issuer |
---|---|---|---|
1235968751 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
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