Organization
PERFORMANCE ABA THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EBONY POWELL (OWNER)
(770) 895-2978
Entity
Organization
Contact information
Practice address
2131 STALLINGS ST NW # 2832, COVINGTON, GA 30014-2351
(770) 895-2978
Mailing address
2131 STALLINGS ST NW # 2832, COVINGTON, GA 30014-2351
(770) 895-2978
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
106S00000X
Behavior Technician
—
—
Other
Enumeration date
07/05/2023
Last updated
07/05/2023
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