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Organization

THWEATT ADVANCED BEHAVIOR ASSOCIATES

Active
Other names
Thweatt Advanced Behavior Associates
Organization subpart
No

Provider details

NPI number
Authorized official
MS. JACQUELINE RENEE THOMAS THWEATT-BURTON M.ED., BCBA, LBA (EXECUTIVE DIRECTOR)
(731) 614-3101
Entity
Organization

Contact information

Practice address
708 BROAD AVE, GULFPORT, MS 39501-1350
(731) 614-3101
(228) 300-2113
Mailing address
708 BROAD AVE, GULFPORT, MS 39501-1350
(731) 614-3101
(228) 300-2113

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0000000623
TENNESSEE DEPARTMENT OF HEALTH
TN
05
06888361
MS
01
200005
MISSISSIPPI AUTISM BOARD
MS
01
LBA0000000627
ALABAMA BEHAVIOR ANALYST LICENSING BOARD
AL
Enumeration date
06/17/2022
Last updated
07/20/2022
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