Healthcare Provider Details

I. General information

NPI: 1497676399
Provider Name (Legal Business Name): BEYHANY SPOHN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/24/2026
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

727 W 6TH ST
WAYNESBORO GA
30830-4407
US

IV. Provider business mailing address

PO BOX 14067
AUGUSTA GA
30919-0067
US

V. Phone/Fax

Practice location:
  • Phone: 706-437-0505
  • Fax: 706-554-6219
Mailing address:
  • Phone: 706-437-0505
  • Fax: 706-554-6219

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-26-2831851
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: