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General NPI Number Information
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NPI Number | 1558115675
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Entity Type | Individual
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Provider Name | CODY MCPHAIL DRUMMOND
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Gender | Male
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Dates
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Enumeration Date | 04/15/2024
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Last Update Date | 04/15/2024
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Provider Practice Location Address
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Address Line | 7302 MS-613 SUITE B
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City | MOSS POINT
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State | MS
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Zip | 39563
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Country | US
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Telephone | 228-623-5454
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Fax |
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Provider Business Mailing Address
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Address Line | 7570 CURTIS DR
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City | IRVINGTON
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State | AL
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Zip | 36544-3838
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Country | US
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Telephone | 228-623-5454
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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 | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number | BACB606940
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License Number State | AL
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