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NPI 1982415840

NPI 1982415840 : RISING STEPS ABA : JEFFERSON, GA

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General NPI Number Information
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    NPI Number           |    1982415840
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    Entity Type          |    Organization 
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    Legal Business Name  |    RISING STEPS ABA 
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Dates
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    Enumeration Date     |    01/18/2025
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    Last Update Date     |    01/18/2025
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Provider Practice Location Address
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    Address Line         |    1325 RIVER MIST CIR 
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    City                 |    JEFFERSON
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    State                |    GA
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    Zip                  |    30549-7750
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    Country              |    US
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    Telephone            |    470-774-7716
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    1325 RIVER MIST CIR 
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    City                 |    JEFFERSON
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    State                |    GA
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    Zip                  |    30549-7750
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    Country              |    US
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    Telephone            |    470-774-7716
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    Fax                  |    
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Authorized Official
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    Title or Position    |    BCBA
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    Name                 |     BERHANE  DE BARROS 
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    Credential           |    MS
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    Telephone            |    470-774-7716
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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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