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General NPI Number Information
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NPI Number | 1487267308
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Entity Type | Individual
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Provider Name | ABIGAIL GRACE MEYER BCBA
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Gender | Female
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Dates
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Enumeration Date | 08/29/2020
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Last Update Date | 01/04/2024
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Provider Practice Location Address
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Address Line | 3335 LT MOSS RD
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City | MISSOULA
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State | MT
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Zip | 59804-7222
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Country | US
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Telephone | 406-549-6413
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Fax |
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Provider Business Mailing Address
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Address Line | 3335 LT MOSS RD
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City | MISSOULA
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State | MT
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Zip | 59804-7222
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Country | US
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Telephone |
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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 | PSY-ABA-LIC-4664
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License Number State | MT
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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 | PSY-ABA-LIC-4110
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License Number State | MT
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Taxonomy #3
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number | 17-35537
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License Number State | MT
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Taxonomy #4
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | PSY-BA-LIC-4664
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License Number State | MT
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