| Willow Aba Services Llc | |
|
2815 Exchange Blvd Ste 100 Southlake TX 76092-7515 | |
| (913) 375-3626 | |
| Not Available |
| Full Name | Willow Aba Services Llc |
|---|---|
| Speciality | Behavior Analyst |
| Location | 2815 Exchange Blvd Ste 100, Southlake, Texas |
| Authorized Official Name and Position | Tanner Sierks (OWNER) |
| Authorized Official Contact | 9133753626 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Willow Aba Services Llc 7150 Campus Dr Ste 290 Colorado Springs CO 80920-6508 Ph: (913) 375-3626 | Willow Aba Services Llc 2815 Exchange Blvd Ste 100 Southlake TX 76092-7515 Ph: (913) 375-3626 |
| NPI Number | 1639704372 |
|---|---|
| Provider Enumeration Date | 03/03/2020 |
| Last Update Date | 03/03/2020 |
| Certification Date | 03/03/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639704372 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
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