Organization
UPWARD ABA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. BRANDEE L MASTERSON MS, BCBA (EXECUTIVE DIRECTOR)
(731) 234-1873
Entity
Organization
Contact information
Practice address
6858 SWINNEA RD BLDG 6B, SOUTHAVEN, MS 38671-9493
(662) 426-6136
(662) 499-6136
Mailing address
6858 SWINNEA RD BLDG 6B, SOUTHAVEN, MS 38671-9493
(662) 426-6136
(662) 499-6136
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1811467731
NPI
TN
05
—
1962751933
—
TN
Enumeration date
04/14/2021
Last updated
09/21/2021
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