NPI 1104331552 · live from the CMS NPI Registry
Savannah Anderson
Behavior Analyst in Saint Marys, GA. National Provider Identifier 1104331552, active.
NPI record
| NPI | 1104331552 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Behavior Analyst 103K00000X |
| Practice location | 107 Industrial Dr Ste E, Saint Marys, GA 31558 |
| Practice phone | 904-538-0713 |
| Mailing address | 10175 Fortune Pkwy Unit 903, Jacksonville, FL 32256 |
| Enumerated | December 7, 2017 |
| Last updated | January 24, 2022 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Behavior Technician | 106S00000X | RBT-17-30465 |
| Behavior Analyst primary | 103K00000X | 1-21-53069 (GA) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.