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General NPI Number Information
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NPI Number | 1528567229
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Entity Type | Individual
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Provider Name | NICHOLAS LOBIONDO BCABA
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Gender | Male
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Dates
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Enumeration Date | 02/08/2018
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Last Update Date | 05/03/2021
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Provider Practice Location Address
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Address Line | 107 SOUTHERN BLVD STE 201
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City | SAVANNAH
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State | GA
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Zip | 31405-7441
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Country | US
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Telephone | 800-844-1232
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Fax | 848-844-1232
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Provider Business Mailing Address
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Address Line | 1135 FORDS POINTE CIR
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City | SAVANNAH
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State | GA
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Zip | 31419-8118
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Country | US
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Telephone | 848-333-7336
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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 |
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License Number State |
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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 | 0-21-12068
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License Number State | GA
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