Provider Demographics
NPI:1386342806
Name:UNIQUELY U AUTISM CENTER LLC
Entity type:Organization
Organization Name:UNIQUELY U AUTISM CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR/BCBA
Authorized Official - Prefix:
Authorized Official - First Name:DIANA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:DRAGHI
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:470-836-0699
Mailing Address - Street 1:4506 BALMORAL RD NW
Mailing Address - Street 2:
Mailing Address - City:KENNESAW
Mailing Address - State:GA
Mailing Address - Zip Code:30144-5141
Mailing Address - Country:US
Mailing Address - Phone:470-836-0699
Mailing Address - Fax:470-922-5246
Practice Address - Street 1:1275 SHILOH RD NW STE 2020
Practice Address - Street 2:
Practice Address - City:KENNESAW
Practice Address - State:GA
Practice Address - Zip Code:30144-7199
Practice Address - Country:US
Practice Address - Phone:470-836-0699
Practice Address - Fax:470-922-5246
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-23
Last Update Date:2023-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty