NPI 1356913438 · live from the CMS NPI Registry
Corey Blagsvedt, RBT
Behavior Analyst in Charleston, SC. National Provider Identifier 1356913438, active.
NPI record
| NPI | 1356913438 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Behavior Analyst 103K00000X |
| Practice location | 2413 Savannah Hwy, Charleston, SC 29414 |
| Practice phone | 843-449-0554 |
| Mailing address | 1508 Azalea Dr, Myrtle Beach, Myrtle Beach, Sc, SC 29575 |
| Enumerated | July 16, 2021 |
| Last updated | July 16, 2021 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Behavior Analyst primary | 103K00000X | 17-38371 (SC) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.