NPI 1104582964 · live from the CMS NPI Registry
Autism Therapeutic Services
Behavior Analyst in Louisville, KY. National Provider Identifier 1104582964, active.
NPI record
| NPI | 1104582964 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Behavior Analyst 103K00000X |
| Practice location | 9850 Von Allmen Ct Ste 201, Louisville, KY 40241 |
| Practice phone | 910-484-1711 |
| Mailing address | 568 Sandhurst Dr, Fayetteville, NC 28304 |
| Enumerated | November 16, 2021 |
| Last updated | November 10, 2023 |
| Authorized official | Terra Scott, Svp Outpatient Pediatrics |
| Other names | Healthpro Pediatrics |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Clinic/Center, Multi-Specialty | 261QM1300X | — |
| Assistant Behavior Analyst | 106E00000X | — |
| Behavior Technician | 106S00000X | — |
| Behavior Analyst primary | 103K00000X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.