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NPI Code Detail

MEDICARE: ALICE ANN EATON MSW, BCBA, LBA

MEDICARE: ALICE ANN EATON MSW, 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
1103K00000XBehavior AnalystNC

General Provider Information

NPI Number : 1548650500
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALICE ANN EATON MSW, BCBA, LBA
Provider Business Mailing Address
First Line : 27777 INKSTER RD STE 100
Second Line :
City : FARMINGTON HILLS
State : MI
Zip : 48334-5312
Country : US
Telephone Number : 855-772-8847
Fax Number :
Provider Business Practice Location Address
First Line : 1615 SPRING GARDEN ST
Second Line :
City : GREENSBORO
State : NC
Zip : 27403-2334
Country : US
Telephone Number : 855-772-8847
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/29/2015
Last Update Date : 09/16/2025

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