| NPI | 1932721693 |
|---|---|
| Doing Business As | STARDUST ABA |
| Entity Type | Organization |
| Authorized Contact | MAIZEL QUIVA Co Owner 757-752-6900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2020-05-15 |
| Last Update Date | 2020-05-15 |