Organization
MUSTARD SEED AUTISM PROJECT, INC
Active
Other names
ABA Academy
Organization subpart
No
Provider details
NPI number
Authorized official
MS. NANCY WAGNER BCBA (EXECUTIVE DIRECTOR)
(817) 277-8870
Entity
Organization
Contact information
Practice address
3605 WEST PIONEER PKWY., SUITE C, ARLINGTON, TX 76013-4500
(817) 277-8870
(817) 277-8875
Mailing address
PO BOX 14597, ARLINGTON, TX 76094-1597
(817) 277-8870
(817) 277-8875
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1073398
TX
251S00000X
Community/Behavioral Health Agency
1-07-3398
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1-07-3398
BCBA CERTIFICATION
TX
01
—
1-15-19081
BCBA CERTIFICATION
TX
01
—
1-16-21569
BEHAVIOR ANALYST CERTIFICATION BOARD- BCBA
TX
Enumeration date
05/22/2007
Last updated
10/25/2016
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