Provider Demographics
NPI:1255202917
Name:DEVELOPMENTAL JOURNEYS ABA, LLC
Entity type:Organization
Organization Name:DEVELOPMENTAL JOURNEYS ABA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LORI
Authorized Official - Middle Name:
Authorized Official - Last Name:WALTMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:618-531-0619
Mailing Address - Street 1:1300 GRANT RD
Mailing Address - Street 2:
Mailing Address - City:WATERTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:37184-0600
Mailing Address - Country:US
Mailing Address - Phone:615-281-9514
Mailing Address - Fax:
Practice Address - Street 1:1300 GRANT RD
Practice Address - Street 2:
Practice Address - City:WATERTOWN
Practice Address - State:TN
Practice Address - Zip Code:37184-0600
Practice Address - Country:US
Practice Address - Phone:618-531-0619
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-16
Last Update Date:2025-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty