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General NPI Number Information
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NPI Number | 1720939507
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Entity Type | Organization
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Legal Business Name | FIRST ADVANTAGE
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Dates
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Enumeration Date | 02/06/2026
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Last Update Date | 02/06/2026
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Provider Practice Location Address
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Address Line | 1209 OAKDALE ST
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City | SPRINGFIELD
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State | IL
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Zip | 62703-2045
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Country | US
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Telephone | 217-836-5775
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Fax |
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Provider Business Mailing Address
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Address Line | 1209 OAKDALE ST
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City | SPRINGFIELD
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State | IL
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Zip | 62703-2045
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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 | BEHAVIORAL TECHNICIAN
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Name | RANIYAH DOWDELL
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Credential |
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Telephone | 217-836-5775
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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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