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NPI Code Detail

MEDICARE: MS. NANNAPAT MEETAM BCBA

MEDICARE:  MS. NANNAPAT  MEETAM  BCBA
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
1106S00000XBehavior Technician
2103K00000XBehavior Analyst1-20-41175IL

General Provider Information

NPI Number : 1548772288
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. NANNAPAT MEETAM BCBA
Provider Business Mailing Address
First Line : 8421 STRATFORD DR
Second Line :
City : TINLEY PARK
State : IL
Zip : 60487-2119
Country : US
Telephone Number : 708-655-4252
Fax Number :
Provider Business Practice Location Address
First Line : 8200 185TH ST STE AB
Second Line :
City : TINLEY PARK
State : IL
Zip : 60487-9232
Country : US
Telephone Number : 708-580-0440
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/03/2017
Last Update Date : 03/06/2020

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Directions to “ MS. NANNAPAT MEETAM BCBA” Practice Location

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