NPI 1275868556 · live from the CMS NPI Registry
Atlas Supports
Behavior Analyst in Leesville, SC. National Provider Identifier 1275868556, active.
NPI record
| NPI | 1275868556 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Behavior Analyst 103K00000X |
| Practice location | 113 Saluda Shores Cir, Leesville, SC 29070 |
| Practice phone | 803-582-9003 |
| Enumerated | October 5, 2009 |
| Last updated | April 22, 2015 |
| Authorized official | Christian Martin, President |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Behavior Analyst primary | 103K00000X | 1-05-2205 (SC) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.