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Organization
AUTISM BEHAVIORAL ASSOCIATES LLC
Active
Organization
AUTISM BEHAVIORAL ASSOCIATES LLC
Active
Other names
Divergent Abilities
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHANIE MICHELLE MARTINEZ BCBA, LBA (CO-FOUNDER/BEHAVIOR ANALYST)
(512) 550-7472
Entity
Organization
Contact information
Practice address
1503 BALSAM WAY, ROUND ROCK, TX 78665-2389
(512) 550-7472
Mailing address
1503 BALSAM WAY, ROUND ROCK, TX 78665-2389
(512) 550-7472
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4314395
—
TX
Enumeration date
11/13/2021
Last updated
08/02/2024
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