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NPI Code Detail

MEDICARE: ANNA MORGAN DELUCENAY M.S., BCBA, LBA

MEDICARE: ANNA MORGAN DELUCENAY M.S., BCBA, LBA
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
1106S00000XBehavior TechnicianRBT-18-48660TN
2103K00000XBehavior Analyst633TN

General Provider Information

NPI Number : 1528551561
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANNA MORGAN DELUCENAY M.S., BCBA, LBA
Provider Business Mailing Address
First Line : 215 S COLLEGE ST
Second Line :
City : WINCHESTER
State : TN
Zip : 37398-1519
Country : US
Telephone Number : 931-967-0626
Fax Number : 931-962-1533
Provider Business Practice Location Address
First Line : 215 S COLLEGE ST
Second Line :
City : WINCHESTER
State : TN
Zip : 37398-1519
Country : US
Telephone Number : 931-967-0626
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/13/2018
Last Update Date : 06/05/2020

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