MEDICARE: SYMPATHETIC STEPS TO SUCCESS, LLC

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	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1841567518
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SYMPATHETIC STEPS TO SUCCESS, LLC

Provider Business Mailing Address
First Line	:	6510 STAGE RD
Second Line	:	SUITE 2
City	:	BARTLETT
State	:	TN
Zip	:	38134-3892
Country	:	US
Telephone Number	:	901-382-3636
Fax Number	:	901-382-0830

Provider Business Practice Location Address
First Line	:	6510 STAGE RD
Second Line	:	SUITE 2
City	:	BARTLETT
State	:	TN
Zip	:	38134-3892
Country	:	US
Telephone Number	:	901-382-3636
Fax Number	:	901-382-0830

Authorized Official
Title or Position	:	OWNER/CEO
Name	:	MR. JURICUS C BOYD
Credential	:	BCBA
Telephone Number	:	901-428-3625

Provider Enumeration Date	:	11/25/2011
Last Update Date	:	11/25/2011

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