# SOUTHSIDE ABA LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1134759608
- **Authorized official:** CHRISTINE ELAINE MARRERO BCBA (CLINICAL DIRECTOR)
- **Authorized official phone:** (770) 707-6367

## Contact information

- **Practice address:** 1135 SENOIA RD, TYRONE, GA 30290-1625
- **Practice address phone:** (770) 626-3044
- **Practice address fax:** (470) 200-2269
- **Mailing address:** 1135 SENOIA RD, TYRONE, GA 30290-1625
- **Mailing address phone:** (770) 626-3044
- **Mailing address fax:** (470) 200-2269

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 103K00000X | Behavior Analyst | — | NULL | Yes |
| 103K00000X | Behavior Analyst | — | — | Yes |

## Other

- **Enumeration date:** 01/23/2020
- **Last updated:** 01/23/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 003218736A | — | GA |