Provider Demographics
NPI:1033553441
Name:AUTISM AND BEHAVIORAL INTERVENTION SERVICES, LLC
Entity Type:Organization
Organization Name:AUTISM AND BEHAVIORAL INTERVENTION SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER AND BEHAVIOR ANALYST
Authorized Official - Prefix:DR
Authorized Official - First Name:GEETIKA
Authorized Official - Middle Name:
Authorized Official - Last Name:AGARWAL
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:678-814-7994
Mailing Address - Street 1:1910 CEDAR GLENN
Mailing Address - Street 2:UNIT 4301
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30339-8541
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1910 CEDAR GLENN
Practice Address - Street 2:UNIT 4301
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30339-8541
Practice Address - Country:US
Practice Address - Phone:678-814-7994
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-29
Last Update Date:2013-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA1-11-9001103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty