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Organization

UPWARD AUTISM CENTER LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. RAVEN THOMAS MS, BCBA (OWNER/CENTER DIRECTOR)
(502) 338-4266
Entity
Organization

Contact information

Practice address
4400 BROWNSVILLE RD STE #105 #3080, POWDER SPRINGS, GA 30127-8902
(470) 333-2051
(678) 669-2694
Mailing address
4400 BROWNSVILLE RD STE #105 #3080, POWDER SPRINGS, GA 30127-8902
(470) 333-2051
(678) 669-2694

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1-18-32530
BCBA CERTIFICATE
GA
Enumeration date
08/19/2021
Last updated
04/11/2023
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