Provider Demographics
NPI:1982472791
Name:TOUCHED BY AN ANGEL ABA SERVICES LLC
Entity Type:Organization
Organization Name:TOUCHED BY AN ANGEL ABA SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER / OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHAWANZA
Authorized Official - Middle Name:LATRISA
Authorized Official - Last Name:DILLARD
Authorized Official - Suffix:
Authorized Official - Credentials:BEHAVIOR TECHNICIAN
Authorized Official - Phone:407-272-7823
Mailing Address - Street 1:1843 PAGE LEIGH CIR APT 1621
Mailing Address - Street 2:
Mailing Address - City:APOPKA
Mailing Address - State:FL
Mailing Address - Zip Code:32703-3480
Mailing Address - Country:US
Mailing Address - Phone:407-272-7823
Mailing Address - Fax:
Practice Address - Street 1:1403 W COLONIAL DR STE A
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32804-7118
Practice Address - Country:US
Practice Address - Phone:407-272-7823
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-12
Last Update Date:2023-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior AnalystGroup - Multi-Specialty
No106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Multi-Specialty
No224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy AssistantGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No252Y00000XAgenciesEarly Intervention Provider Agency
No261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental DisabilitiesGroup - Multi-Specialty