MEDICARE: AALIYAH BUSBY

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	106E00000X	Assistant Behavior Analyst	0-26-16845	SC

General Provider Information

NPI Number	:	1114608163
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AALIYAH BUSBY

Provider Business Mailing Address
First Line	:	7224 HARCOURT XING
Second Line	:
City	:	INDIAN LAND
State	:	SC
Zip	:	29707-5843
Country	:	US
Telephone Number	:	803-902-5943
Fax Number	:	803-675-0443

Provider Business Practice Location Address
First Line	:	885 GOLD HILL RD # 3104
Second Line	:
City	:	FORT MILL
State	:	SC
Zip	:	29708-7946
Country	:	US
Telephone Number	:	803-902-5943
Fax Number	:	803-675-0443

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

Provider Enumeration Date	:	07/31/2023
Last Update Date	:	02/04/2026

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