Organization
AUTISM BEHAVIOR SUPPORT, LLC
Active
Other names
Mary Ayala
Organization subpart
No
Provider details
NPI number
Authorized official
MARY C AYALA BCBA, LBA (OWNER)
(719) 352-2970
Entity
Organization
Contact information
Practice address
4003 W STAN SCHLUETER LOOP STE 3, KILLEEN, TX 76549-6120
(719) 352-2970
(254) 267-1091
Mailing address
5212 ALLEGANY DR, KILLEEN, TX 76549-5648
(719) 352-2970
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
106S00000X
Behavior Technician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
TRICARE
TRICARE
TX
Enumeration date
01/20/2020
Last updated
07/20/2020
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