MEDICARE: AMY INMAN BCBA

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
1	103K00000X	Behavior Analyst	1-17-28296	GA

General Provider Information

NPI Number	:	1073924973
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMY INMAN BCBA

Provider Business Mailing Address
First Line	:	105 GREEN RIDGE DR
Second Line	:
City	:	EASLEY
State	:	SC
Zip	:	29642-7736
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3343 PEACHTREE RD NE STE 145-2576
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30326-1085
Country	:	US
Telephone Number	:	470-658-6560
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/13/2014
Last Update Date	:	01/23/2026

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