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NPI Code Detail

MEDICARE: HOPE L KALU RBT-19-108411

MEDICARE: HOPE L KALU RBT-19-108411
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 TechnicianRBT-19-108411SC
2103K00000XBehavior Analyst

General Provider Information

NPI Number : 1023639580
Entity Type Code : Individual
Provider Name (Legal Business Name) : HOPE L KALU RBT-19-108411
Provider Business Mailing Address
First Line : 209 7TH ST FL 3
Second Line :
City : AUGUSTA
State : GA
Zip : 30901-1486
Country : US
Telephone Number : 706-842-5330
Fax Number : 706-842-5340
Provider Business Practice Location Address
First Line : 1022 CALHOUN ST # 202
Second Line :
City : COLUMBIA
State : SC
Zip : 29201-2406
Country : US
Telephone Number : 803-335-0718
Fax Number : 704-788-2016
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/06/2020
Last Update Date : 05/02/2025

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Directions to “ HOPE L KALU RBT-19-108411” Practice Location

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