Healthcare Provider Details

I. General information

NPI: 1538781570
Provider Name (Legal Business Name): ANKITA ANIL TENDOLKAR BCBA BEHAVIOR ANALYS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/13/2020
Last Update Date: 12/13/2025
Certification Date: 12/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4375 RIVER GREEN PKWY STE 150
DULUTH GA
30096-8319
US

IV. Provider business mailing address

4375 RIVER GREEN PKWY STE 150
DULUTH GA
30096-8319
US

V. Phone/Fax

Practice location:
  • Phone: 404-474-2122
  • Fax:
Mailing address:
  • Phone: 404-474-2122
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: