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Organization
MAGNOLIA ABA INSTITUTE, INC
Active
Organization
MAGNOLIA ABA INSTITUTE, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID G MARTIN M.ED., B.C.B.A. (EXECUTIVE DIRECTOR)
(615) 613-1869
Entity
Organization
Contact information
Practice address
279 CLEAR SKY CT, SUITE C, CLARKSVILLE, TN 37043-5946
(615) 613-1869
(931) 443-0203
Mailing address
7944 PRINCETON DR, NAPLES, FL 34104-6667
(615) 613-1869
(931) 443-0203
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
000856685
TN
Other
Enumeration date
08/10/2016
Last updated
08/10/2016
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