NPI 1417524307 · live from the CMS NPI Registry
A Leap Beyond Autism Services, LLC
Behavior Analyst in Tyrone, GA. National Provider Identifier 1417524307, active.
NPI record
| NPI | 1417524307 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Behavior Analyst 103K00000X |
| Practice location | 110 Newfield Dr, Tyrone, GA 30290 |
| Practice phone | 678-862-6226 |
| Mailing address | 100 Commerce Dr Unit 452, Tyrone, GA 30290 |
| Enumerated | June 8, 2021 |
| Last updated | October 6, 2022 |
| Authorized official | Tia Penn-Tabor, Ceo |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Behavior Analyst primary | 103K00000X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.