Healthcare Provider Details

I. General information

NPI: 1245715614
Provider Name (Legal Business Name): MEANINGFUL MILESTONES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/01/2018
Last Update Date: 05/28/2020
Certification Date: 05/28/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

460 PIN OAK DR
LEXINGTON SC
29073-7916
US

IV. Provider business mailing address

460 PIN OAK DR
LEXINGTON SC
29073-7916
US

V. Phone/Fax

Practice location:
  • Phone: 814-441-5938
  • Fax:
Mailing address:
  • Phone: 814-441-5938
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name: JACQUELINE ABRAMS
Title or Position: MANAGING MEMBER
Credential: BCBA
Phone: 803-714-3446