MEDICARE: MRS. HANNAH CHANDLEE BOREK BCABA, LABA

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	2017-089	AL

General Provider Information

NPI Number	:	1215317284
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. HANNAH CHANDLEE BOREK BCABA, LABA

Provider Business Mailing Address
First Line	:	203 NARROWS PKWY STE B
Second Line	:
City	:	BIRMINGHAM
State	:	AL
Zip	:	35242-8649
Country	:	US
Telephone Number	:	205-362-7035
Fax Number	:

Provider Business Practice Location Address
First Line	:	203 NARROWS PKWY STE B
Second Line	:
City	:	BIRMINGHAM
State	:	AL
Zip	:	35242-8649
Country	:	US
Telephone Number	:	205-362-7035
Fax Number	:

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

Provider Enumeration Date	:	06/04/2015
Last Update Date	:	09/28/2020

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