Provider Demographics
NPI:1699200832
Name:FUNCTIONAL SKILLS ABA, LLC
Entity type:Organization
Organization Name:FUNCTIONAL SKILLS ABA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:KILLION
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:864-684-8343
Mailing Address - Street 1:9 WOLLASTON DR
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29617-7943
Mailing Address - Country:US
Mailing Address - Phone:864-684-8343
Mailing Address - Fax:
Practice Address - Street 1:9 WOLLASTON DR
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29617-7943
Practice Address - Country:US
Practice Address - Phone:864-684-8343
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-25
Last Update Date:2017-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty