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Organization
THWEATT ADVANCED BEHAVIOR ASSOCIATES
Active
Organization
THWEATT ADVANCED BEHAVIOR ASSOCIATES
Active
Other names
Thweatt Advanced Behavior Associates
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JACQUELINE RENEE THOMAS THWEATT-BURTON M.ED., BCBA, LBA (EXECUTIVE DIRECTOR)
(731) 614-3101
Entity
Organization
Contact information
Practice address
708 BROAD AVE, GULFPORT, MS 39501-1350
(731) 614-3101
(228) 300-2113
Mailing address
708 BROAD AVE, GULFPORT, MS 39501-1350
(731) 614-3101
(228) 300-2113
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000000623
TENNESSEE DEPARTMENT OF HEALTH
TN
05
—
06888361
—
MS
01
—
200005
MISSISSIPPI AUTISM BOARD
MS
01
—
LBA0000000627
ALABAMA BEHAVIOR ANALYST LICENSING BOARD
AL
Enumeration date
06/17/2022
Last updated
07/20/2022
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