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General NPI Number Information
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NPI Number | 1174284657
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Entity Type | Individual
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Provider Name | MORGAN GILES IRIZARRY
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Gender | Female
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Dates
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Enumeration Date | 01/06/2022
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Last Update Date | 05/05/2025
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Provider Practice Location Address
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Address Line | 2144 SUMTER ST
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City | COLUMBIA
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State | SC
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Zip | 29201-2182
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Country | US
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Telephone | 803-258-0533
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Fax |
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Provider Business Mailing Address
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Address Line | 1624 MALCOLM DR
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City | COLUMBIA
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State | SC
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Zip | 29204-3011
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Country | US
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Telephone | 417-619-0624
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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 | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | BCBA-1-25-79490
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License Number State | SC
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