Provider Demographics
NPI:1861742611
Name:ALABAMA AUTISM ASSISTANCE PROGRAM
Entity type:Organization
Organization Name:ALABAMA AUTISM ASSISTANCE PROGRAM
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:COURTNEY
Authorized Official - Middle Name:DEES
Authorized Official - Last Name:KING
Authorized Official - Suffix:
Authorized Official - Credentials:MS, BCBA
Authorized Official - Phone:205-733-0976
Mailing Address - Street 1:300 SHADOW WOOD PARK STE 100
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35244-3411
Mailing Address - Country:US
Mailing Address - Phone:205-733-0976
Mailing Address - Fax:205-733-0977
Practice Address - Street 1:300 SHADOW WOOD PARK STE 100
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35244-3411
Practice Address - Country:US
Practice Address - Phone:205-733-0976
Practice Address - Fax:205-733-0977
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-19
Last Update Date:2012-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1041480103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty