NPI 1316218936 · live from the CMS NPI Registry
Autism & Behavior Consultants,LLC
Behavior Analyst in Poplar Bluff, MO. National Provider Identifier 1316218936, active.
NPI record
| NPI | 1316218936 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Behavior Analyst 103K00000X |
| Practice location | 234 South Dr., Poplar Bluff, MO 63901 |
| Practice phone | 573-714-6855 |
| Enumerated | January 13, 2012 |
| Last updated | December 7, 2012 |
| Authorized official | Jennifer Nowak, Owner/Director |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Behavior Analyst | 103K00000X | 2011008959 (MO) |
| Speech-Language Pathologist, | 235Z00000X | 2000174350 (MO) |
| Speech-Language Pathologist, | 235Z00000X | 2006011487 (MO) |
| Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | 320900000X | — |
| Behavior Analyst primary | 103K00000X | 20110000573 (MO) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.