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NPI Code Detail

MEDICARE: MS. ELIZABETH HOPE TEDESCUCCI

MEDICARE: MS. ELIZABETH HOPE TEDESCUCCI
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1003574559
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. ELIZABETH HOPE TEDESCUCCI
Provider Business Mailing Address
First Line : 2244 NORTH RD STE 116
Second Line :
City : GARDENDALE
State : AL
Zip : 35071-2258
Country : US
Telephone Number : 833-825-5246
Fax Number :
Provider Business Practice Location Address
First Line : 2244 NORTH RD STE 116
Second Line :
City : GARDENDALE
State : AL
Zip : 35071-2258
Country : US
Telephone Number : 833-825-5246
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/01/2021
Last Update Date : 12/01/2021

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