| Upward Autism Center Llc | |
|
4400 Brownsville Rd Ste #105 #3080 Powder Springs GA 30127-8902 | |
| (470) 333-2051 | |
| (678) 669-2694 |
| Full Name | Upward Autism Center Llc |
|---|---|
| Speciality | Behavior Analyst |
| Location | 4400 Brownsville Rd Ste #105 #3080, Powder Springs, Georgia |
| Authorized Official Name and Position | Raven Thomas (OWNER/CENTER DIRECTOR) |
| Authorized Official Contact | 5023384266 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Upward Autism Center Llc 4400 Brownsville Rd Ste #105 #3080 Powder Springs GA 30127-8902 Ph: (470) 333-2051 | Upward Autism Center Llc 4400 Brownsville Rd Ste #105 #3080 Powder Springs GA 30127-8902 Ph: (470) 333-2051 |
| NPI Number | 1558037507 |
|---|---|
| Provider Enumeration Date | 08/19/2021 |
| Last Update Date | 04/11/2023 |
| Certification Date | 04/11/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558037507 | NPI | - | NPPES |
| 1-18-32530 | Other | GA | BCBA CERTIFICATE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
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