Provider Demographics
NPI:1003469339
Name:POSITIVE DIFFERENCES ABA
Entity Type:Organization
Organization Name:POSITIVE DIFFERENCES ABA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, LEAD CLINICAN
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:EBOZUE
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:404-721-1888
Mailing Address - Street 1:1100 PEACHTREE ST NE STE 200
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30309-4829
Mailing Address - Country:US
Mailing Address - Phone:404-721-1888
Mailing Address - Fax:
Practice Address - Street 1:1100 PEACHTREE ST NE STE 200
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30309-4829
Practice Address - Country:US
Practice Address - Phone:404-721-1888
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-16
Last Update Date:2019-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental TherapistGroup - Multi-Specialty