Provider Demographics
NPI:1801473533
Name:DAYTASTIC ABA, LLC
Entity type:Organization
Organization Name:DAYTASTIC ABA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BEHAVIOR ANALYST
Authorized Official - Prefix:
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:FELSKE
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:281-883-8783
Mailing Address - Street 1:116 W SHERMAN WAY STE 1
Mailing Address - Street 2:
Mailing Address - City:NIXA
Mailing Address - State:MO
Mailing Address - Zip Code:65714-9022
Mailing Address - Country:US
Mailing Address - Phone:417-298-0984
Mailing Address - Fax:
Practice Address - Street 1:116 W SHERMAN WAY STE 1
Practice Address - Street 2:
Practice Address - City:NIXA
Practice Address - State:MO
Practice Address - Zip Code:65714-9022
Practice Address - Country:US
Practice Address - Phone:417-298-0984
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-27
Last Update Date:2021-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty