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NPI Code Detail

MEDICARE: REBECCA BIRCH BCBA

MEDICARE: REBECCA BIRCH 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
1103K00000XBehavior Analyst

General Provider Information

NPI Number : 1487491148
Entity Type Code : Individual
Provider Name (Legal Business Name) : REBECCA BIRCH BCBA
Provider Business Mailing Address
First Line : 11560 GREAT OAKS WAY STE 300
Second Line :
City : ALPHARETTA
State : GA
Zip : 30022-2453
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 11560 GREAT OAKS WAY STE 300
Second Line :
City : ALPHARETTA
State : GA
Zip : 30022-2453
Country : US
Telephone Number : 404-474-2212
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/10/2024
Last Update Date : 07/10/2024

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