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Organization

ABA MOGUL, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MANYA JACKSON MS, BCBA (EXECUTIVE DIRECTOR)
(470) 817-2219
Entity
Organization

Contact information

Practice address
4695 N CHURCH LN SE APT 12301, ATLANTA, GA 30339-0514
(470) 817-2219
Mailing address
4695 N CHURCH LN SE APT 12301, ATLANTA, GA 30339-0514
(470) 817-2219

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary

Other

Enumeration date
06/22/2026
Last updated
06/22/2026
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