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General NPI Number Information
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NPI Number | 1063316883
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Entity Type | Individual
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Provider Name | RENEE LATHAM BCABA
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Gender | Female
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Dates
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Enumeration Date | 10/05/2026
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Last Update Date | 10/05/2026
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Provider Practice Location Address
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Address Line | 120 WICKER PARK AVE
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City | GREER
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State | SC
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Zip | 29651-1948
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Country | US
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Telephone | 865-659-5476
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Fax |
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Provider Business Mailing Address
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Address Line | 6103 CINELLI ST
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City | GREENVILLE
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State | SC
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Zip | 29615-4280
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Country | US
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Telephone | 865-659-5476
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Fax |
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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 | 106E00000X
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Taxonomy Name | Assistant Behavior Analyst
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License Number | 0-26-2854642
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License Number State | SC
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