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NPI Code Detail

MEDICARE: MR. CARTER DYLAN GARLAND I BHT

MEDICARE: MR. CARTER DYLAN GARLAND I BHT
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 : 1073379053
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. CARTER DYLAN GARLAND I BHT
Provider Business Mailing Address
First Line : 180 WELLNESS DR
Second Line :
City : SUMMERSVILLE
State : WV
Zip : 26651-5401
Country : US
Telephone Number : 304-394-4390
Fax Number :
Provider Business Practice Location Address
First Line : 180 WELLNESS DR
Second Line :
City : SUMMERSVILLE
State : WV
Zip : 26651-5401
Country : US
Telephone Number : 304-394-4390
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/26/2024
Last Update Date : 02/26/2024

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