Organization
CREATIVE ABA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALEXIS ROSE WINTERS BCBA (CLINICAL DIRECTOR)
(209) 408-9992
Entity
Organization
Contact information
Practice address
3720 GLENVIEW CIR, MODESTO, CA 95355-1309
(209) 408-9922
Mailing address
3720 GLENVIEW CIR, MODESTO, CA 95355-1309
(209) 408-9922
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
—
Other
Enumeration date
02/23/2022
Last updated
02/25/2022
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