Organization
AUTISM BEHAVIORAL ASSOCIATES LLC
Active
Other names
Divergent Abilities
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHANIE MICHELLE MARTINEZ BCBA, LBA (CO-FOUNDER/BEHAVIOR ANALYST)
(512) 550-7472
Entity
Organization
Contact information
Practice address
1503 BALSAM WAY, ROUND ROCK, TX 78665-2389
(512) 550-7472
Mailing address
1503 BALSAM WAY, ROUND ROCK, TX 78665-2389
(512) 550-7472
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4314395
—
TX
Enumeration date
11/13/2021
Last updated
08/02/2024
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