Provider Demographics
NPI:1144846593
Name:DEVELOPING SUCCESS ABA THERAPY
Entity type:Organization
Organization Name:DEVELOPING SUCCESS ABA THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:TAMMIE
Authorized Official - Middle Name:LYN
Authorized Official - Last Name:PHILLIPS
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:405-394-4831
Mailing Address - Street 1:6700 W MEMORIAL RD APT 421
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73142-6406
Mailing Address - Country:US
Mailing Address - Phone:405-394-4831
Mailing Address - Fax:405-730-6390
Practice Address - Street 1:6700 W MEMORIAL RD APT 421
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73142-6406
Practice Address - Country:US
Practice Address - Phone:405-394-4831
Practice Address - Fax:405-730-6390
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-22
Last Update Date:2020-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty