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General NPI Number Information
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NPI Number | 1063037588
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Entity Type | Individual
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Provider Name | MORGAN PECK BCABA
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Gender | Female
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Dates
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Enumeration Date | 06/10/2020
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Last Update Date | 08/15/2023
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Provider Practice Location Address
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Address Line | 18 MEMORIAL MEDICAL DR
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City | GREENVILLE
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State | SC
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Zip | 29605-4452
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Country | US
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Telephone | 706-842-5330
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Fax | 706-842-5340
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Provider Business Mailing Address
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Address Line | 525 8TH ST P.O. BOX 2567
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City | AUGUSTA
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State | GA
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Zip | 30901-9998
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Country | US
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Telephone | 706-842-5330
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Fax | 706-842-5340
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 1-23-67530
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 106E00000X
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Taxonomy Name | Assistant Behavior Analyst
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License Number |
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License Number State |
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