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General NPI Number Information
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NPI Number | 1629536339
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Entity Type | Organization
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Legal Business Name | THE BEHAVIOR PLACELLC
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Dates
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Enumeration Date | 03/12/2019
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Last Update Date | 05/14/2025
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Provider Practice Location Address
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Address Line | 10545 COLERAIN RD
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City | SAINT MARYS
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State | GA
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Zip | 31558-3720
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Country | US
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Telephone | 912-266-8686
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Fax | 866-764-2841
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Provider Business Mailing Address
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Address Line | 10850 WISTERIA LN
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City | KING GEORGE
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State | VA
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Zip | 22485-3882
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER/DIRECTOR
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Name | LAURA TREST
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Credential |
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Telephone | 425-949-0801
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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 |
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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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