Provider Demographics
NPI:1225899636
Name:HIDDEN TALENTS ABA SC
Entity Type:Organization
Organization Name:HIDDEN TALENTS ABA SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SHALOM
Authorized Official - Middle Name:
Authorized Official - Last Name:KATZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-800-7683
Mailing Address - Street 1:140 STONERIDGE DR STE 430
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29210-8276
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:678-831-3005
Practice Address - Street 1:140 STONERIDGE DR STE 430
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29210-8276
Practice Address - Country:US
Practice Address - Phone:404-487-6005
Practice Address - Fax:678-831-3005
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-22
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty