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NPI Code Detail

MEDICARE: LANDEN WILLIAM WINN MA

MEDICARE: LANDEN WILLIAM WINN MA
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 Technician
2103K00000XBehavior Analyst1-22-61390UT

General Provider Information

NPI Number : 1558825398
Entity Type Code : Individual
Provider Name (Legal Business Name) : LANDEN WILLIAM WINN MA
Provider Business Mailing Address
First Line : 3020I PROSPERITY CHURCH RD # 247
Second Line :
City : CHARLOTTE
State : NC
Zip : 28269-8112
Country : US
Telephone Number : 801-437-0490
Fax Number :
Provider Business Practice Location Address
First Line : 100 BULL ST STE 200
Second Line :
City : SAVANNAH
State : GA
Zip : 31401-3378
Country : US
Telephone Number : 931-288-2422
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/25/2019
Last Update Date : 07/13/2023

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Directions to “ LANDEN WILLIAM WINN MA” Practice Location

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