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General NPI Number Information
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NPI Number | 1609712330
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Entity Type | Organization
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Legal Business Name | ASPEN HORIZON
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Dates
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Enumeration Date | 04/27/2026
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Last Update Date | 04/27/2026
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Provider Practice Location Address
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Address Line | 85 KATELEN CT
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City | COVINGTON
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State | GA
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Zip | 30016-7720
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Country | US
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Telephone | 470-334-3514
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Fax |
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Provider Business Mailing Address
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Address Line | 85 KATELEN CT
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City | COVINGTON
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State | GA
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Zip | 30016-7720
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Country | US
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Telephone | 470-334-3514
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JAVONTE GRAYER
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Credential |
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Telephone | 470-334-3514
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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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