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General NPI Number Information
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NPI Number | 1619637147
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Entity Type | Organization
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Legal Business Name | I PEEP BXS
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Dates
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Enumeration Date | 12/23/2021
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Last Update Date | 11/17/2023
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Provider Practice Location Address
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Address Line | 756 W PEACHTREE ST NW FL 4
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City | ATLANTA
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State | GA
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Zip | 30308-2378
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Country | US
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Telephone | 762-622-8360
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Fax | 888-720-3196
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Provider Business Mailing Address
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Address Line | PO BOX 19525
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City | ATLANTA
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State | GA
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Zip | 30325-0525
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Country | US
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Telephone | 762-622-8360
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Fax | 888-720-3196
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Authorized Official
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Title or Position | BOARD CERTIFIED BEHAVIOR ANALYST
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Name | DONTA HALLMON
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Credential | BCBA
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Telephone | 762-622-8360
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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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 | 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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