Provider Demographics
NPI:1972125672
Name:ABSOLUTE BEHAVIOR ADVANCEMENT
Entity Type:Organization
Organization Name:ABSOLUTE BEHAVIOR ADVANCEMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BCBA
Authorized Official - Prefix:MISS
Authorized Official - First Name:LADELRIE
Authorized Official - Middle Name:SHANIKA
Authorized Official - Last Name:HALL
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA LBA
Authorized Official - Phone:803-257-4637
Mailing Address - Street 1:23018 SANDPIPER TRL
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77373-5405
Mailing Address - Country:US
Mailing Address - Phone:803-257-4637
Mailing Address - Fax:
Practice Address - Street 1:23018 SANDPIPER TRL
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77373-5405
Practice Address - Country:US
Practice Address - Phone:803-257-4637
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-15
Last Update Date:2020-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty