Full Spectrum ABA of Mississippi LLC

Organization Active NPI Behavior Analyst · Ridgeland, MS

NPI 1164066924 · NPPES record last updated Mar 4, 2020

Key facts

NPI
1164066924
Entity type
Organization (NPI type 2)
Primary specialty
Behavior Analyst 103K00000X
Legal business name
FULL SPECTRUM ABA OF MISSISSIPPI LLC
Practice address
270 Trace Colony Park Dr Ste B
Ridgeland, MS 39157-8810
Phone
(813) 926-5454
NPI assigned
Nov 4, 2019
Organization subpart
No

Authorized official

Name
Collin Edward Streetman, BCBA
Title
Owner
Phone
(813) 926-5454

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst
Group: 193200000X MULTI-SPECIALTY GROUP
103K00000X Yes
Assistant Behavior Analyst
Group: 193200000X MULTI-SPECIALTY GROUP
106E00000X
Behavior Technician
Group: 193200000X MULTI-SPECIALTY GROUP
106S00000X

Addresses

Primary practice location

270 Trace Colony Park Dr Ste B
Ridgeland, MS 39157-8810

Mailing address

270 Trace Colony Park Dr Ste B
Ridgeland, MS 39157-8810

Other providers in Ridgeland, MS

All providers in Ridgeland, MS · Behavior Analyst in Mississippi

Sources for this page

Verify at the official NPI Registry.