MEDICARE: ANISHA MONET PURIFOY

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	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1760954747
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANISHA MONET PURIFOY

Provider Business Mailing Address
First Line	:	2600 VAUGHN LAKES BLVD
Second Line	:
City	:	MONTGOMERY
State	:	AL
Zip	:	36117-4695
Country	:	US
Telephone Number	:	251-253-7588
Fax Number	:

Provider Business Practice Location Address
First Line	:	2185 NORMANDIE DR
Second Line	:
City	:	MONTGOMERY
State	:	AL
Zip	:	36111-2728
Country	:	US
Telephone Number	:	205-612-7797
Fax Number	:

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

Provider Enumeration Date	:	01/01/2019
Last Update Date	:	12/18/2025

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Directions to “ ANISHA MONET PURIFOY ” Practice Location

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