Organization
LEAP FORWARD AUTISM SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANTWANETTE DAILEY BCBA (OWNER)
(757) 593-5662
Entity
Organization
Contact information
Practice address
6303 SAINT CLAIR DR NE, ATLANTA, GA 30329-2677
(757) 593-5662
Mailing address
6303 SAINT CLAIR DR NE, ATLANTA, GA 30329-2677
(757) 593-5662
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
09/08/2023
Last updated
10/18/2023
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