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General NPI Number Information
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NPI Number | 1932746757
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Entity Type | Organization
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Legal Business Name | BEHAVIOR ANALYSIS AND INTERVENTION CENTER
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Dates
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Enumeration Date | 12/01/2019
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Last Update Date | 09/07/2020
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Provider Practice Location Address
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Address Line | 4080 VINE RIDGE DR
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City | POWDER SPRINGS
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State | GA
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Zip | 30127-1788
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Country | US
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Telephone | 404-436-8043
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Fax | 404-500-0506
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Provider Business Mailing Address
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Address Line | PO BOX 1602
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City | POWDER SPRINGS
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State | GA
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Zip | 30127-7520
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Country | US
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Telephone | 404-565-4344
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Fax | 404-500-0506
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | ZAKIRA GOLDEN
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Credential |
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Telephone | 404-565-4344
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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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