Healthcare Provider Details

I. General information

NPI: 1841886660
Provider Name (Legal Business Name): AUDIYA STANLEY BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/16/2020
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

514 W MAPLE ST BLDG 800
CUMMING GA
30040-2420
US

IV. Provider business mailing address

11560 GREAT OAKS WAY STE 300
ALPHARETTA GA
30022-2453
US

V. Phone/Fax

Practice location:
  • Phone: 404-474-0040
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-26-88284
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-20-148422
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: