Healthcare Provider Details

I. General information

NPI: 1578470043
Provider Name (Legal Business Name): AUBREY WILLIFORD
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/27/2026
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6003 VETERANS PKWY
COLUMBUS GA
31909-6200
US

IV. Provider business mailing address

21 LEE ROAD 2056
SALEM AL
36874-4142
US

V. Phone/Fax

Practice location:
  • Phone: 706-222-1222
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT26-519728
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: