Organization
MOMENTUM ABA THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
APRIL ACOSTA NCBA (OWNER)
(901) 314-9722
Entity
Organization
Contact information
Practice address
2125 LEICHESTER LN, MEMPHIS, TN 38134-6971
(901) 314-9722
Mailing address
2125 LEICHESTER LN, MEMPHIS, TN 38134-6971
(901) 314-9722
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
11725115
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q034006
—
TN
Enumeration date
03/03/2018
Last updated
03/03/2018
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