Healthcare Provider Details

I. General information

NPI: 1316337728
Provider Name (Legal Business Name): CHRISTINE ELIZABETH ROBISON HARRIS MAT, BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/23/2015
Last Update Date: 04/17/2026
Certification Date: 04/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1212 AUGUSTA CT
AUGUSTA GA
30901-3257
US

IV. Provider business mailing address

1212 AUGUSTA CT
AUGUSTA GA
30901-3257
US

V. Phone/Fax

Practice location:
  • Phone: 706-826-2770
  • Fax: 706-826-2771
Mailing address:
  • Phone: 706-826-2770
  • Fax: 706-826-2771

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-14-17070
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: