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General NPI Number Information
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NPI Number | 1538978994
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Entity Type | Individual
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Provider Name | KARLEE ELISE LONDON BCBA 1-24-78609
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Gender | Female
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Dates
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Enumeration Date | 12/31/2024
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Last Update Date | 12/31/2024
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Provider Practice Location Address
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Address Line | 1847 RIVERSIDE RIDGE DR
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City | HIAWASSEE
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State | GA
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Zip | 30546-4767
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Country | US
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Telephone | 706-920-0123
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Fax |
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Provider Business Mailing Address
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Address Line | 3196 HWY 515 E UNIT H
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City | BLAIRSVILLE
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State | GA
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Zip | 30512
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Country | US
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Telephone | 706-920-0123
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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 | 1-24-78609
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License Number State | CO
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