MEDICARE: ALANA HEAVEN GEORGE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106S00000X	Behavior Technician
2	103K00000X	Behavior Analyst	1-23-69193	FL

General Provider Information

NPI Number	:	1194379586
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALANA HEAVEN GEORGE

Provider Business Mailing Address
First Line	:	5330 YACHT HAVEN GRANDE STE 201
Second Line	:
City	:	ST THOMAS
State	:	VI
Zip	:	00802-5028
Country	:	US
Telephone Number	:	340-719-7007
Fax Number	:

Provider Business Practice Location Address
First Line	:	5330 YACHT HAVEN GRANDE STE 201
Second Line	:
City	:	ST THOMAS
State	:	VI
Zip	:	00802-5028
Country	:	US
Telephone Number	:	340-719-6655
Fax Number	:	340-719-6655

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/24/2019
Last Update Date	:	03/28/2024

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