Provider Demographics
NPI:1487209888
Name:ABA CLINIC MANAGEMENT
Entity Type:Organization
Organization Name:ABA CLINIC MANAGEMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:RULA
Authorized Official - Middle Name:
Authorized Official - Last Name:DIAB
Authorized Official - Suffix:
Authorized Official - Credentials:MED, BCBA, LBA
Authorized Official - Phone:480-277-3043
Mailing Address - Street 1:9375 E SHEA BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260-6986
Mailing Address - Country:US
Mailing Address - Phone:480-277-3043
Mailing Address - Fax:
Practice Address - Street 1:9375 E SHEA BLVD STE 100
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-6986
Practice Address - Country:US
Practice Address - Phone:480-277-3043
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-03
Last Update Date:2019-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty