Healthcare Provider Details

I. General information

NPI: 1114556131
Provider Name (Legal Business Name): JOSHUA OHISER
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/02/2020
Last Update Date: 01/17/2025
Certification Date: 01/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

460 PIN OAK DR
LEXINGTON SC
29073-7916
US

IV. Provider business mailing address

1505 BLANDING ST
COLUMBIA SC
29201-2906
US

V. Phone/Fax

Practice location:
  • Phone: 803-714-3446
  • Fax: 803-824-6189
Mailing address:
  • Phone: 803-929-0011
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number0-22-13787
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-17-28570
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: