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General NPI Number Information
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NPI Number | 1720964950
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Entity Type | Organization
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Legal Business Name | A PEACH GROW ABA
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Dates
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Enumeration Date | 08/13/2025
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Last Update Date | 08/13/2025
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Provider Practice Location Address
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Address Line | 22 BULL ST STE 300
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City | SAVANNAH
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State | GA
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Zip | 31401-2618
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Country | US
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Telephone | 229-376-0113
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Fax |
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Provider Business Mailing Address
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Address Line | 165 W MULBERRY BLVD APT 4601
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City | SAVANNAH
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State | GA
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Zip | 31407-3670
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Country | US
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Telephone | 229-376-0113
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Fax |
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Authorized Official
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Title or Position | OWNER/CEO
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Name | MS. EBONY NICOLE DAY
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Credential |
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Telephone | 229-376-0113
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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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