| Upward Aba | |
|
6858 Swinnea Rd Bldg 6b Southaven MS 38671-9493 | |
| (662) 426-6136 | |
| (662) 499-6136 |
| Full Name | Upward Aba |
|---|---|
| Speciality | Behavior Analyst |
| Location | 6858 Swinnea Rd Bldg 6b, Southaven, Mississippi |
| Authorized Official Name and Position | Brandee L Masterson (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 7312341873 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Upward Aba 6858 Swinnea Rd Bldg 6b Southaven MS 38671-9493 Ph: (662) 426-6136 | Upward Aba 6858 Swinnea Rd Bldg 6b Southaven MS 38671-9493 Ph: (662) 426-6136 |
| NPI Number | 1730760562 |
|---|---|
| Provider Enumeration Date | 04/14/2021 |
| Last Update Date | 09/21/2021 |
| Certification Date | 09/21/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730760562 | NPI | - | NPPES |
| 1811467731 | Other | TN | NPI |
| 1962751933 | Medicaid | TN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
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