MEDICARE: ADA ELIZABETH GAFFORD

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	106S00000X	Behavior Technician	26-530328	AL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	26-530328	OTHER	AL	26-530328

General Provider Information

NPI Number	:	1760326730
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ADA ELIZABETH GAFFORD

Provider Business Mailing Address
First Line	:	1205-A E COMMERCE ST
Second Line	:
City	:	GREENVILLE
State	:	AL
Zip	:	36037-2115
Country	:	US
Telephone Number	:	334-618-3302
Fax Number	:

Provider Business Practice Location Address
First Line	:	1205-A E COMMERCE ST
Second Line	:
City	:	GREENVILLE
State	:	AL
Zip	:	36037-2115
Country	:	US
Telephone Number	:	334-618-3302
Fax Number	:

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

Provider Enumeration Date	:	04/17/2026
Last Update Date	:	04/17/2026

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Directions to “ ADA ELIZABETH GAFFORD ” Practice Location

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