MEDICARE: JILLIAN PATRIA BCABA

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		NC

General Provider Information

NPI Number	:	1447931217
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JILLIAN PATRIA BCABA

Provider Business Mailing Address
First Line	:	300 KILMER LN
Second Line	:
City	:	MOORESVILLE
State	:	NC
Zip	:	28115-9081
Country	:	US
Telephone Number	:	603-933-1452
Fax Number	:

Provider Business Practice Location Address
First Line	:	6634 OLD STATESVILLE RD
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28269-6768
Country	:	US
Telephone Number	:	704-251-4898
Fax Number	:

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

Provider Enumeration Date	:	07/26/2023
Last Update Date	:	06/16/2026

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Directions to “ JILLIAN PATRIA BCABA” Practice Location

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