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NPI Code Detail

MEDICARE: ALYSSA NADEAU

MEDICARE:   ALYSSA  NADEAU
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

General Provider Information

NPI Number : 1861340267
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALYSSA NADEAU
Provider Business Mailing Address
First Line : 1505 BLANDING ST
Second Line :
City : COLUMBIA
State : SC
Zip : 29201-2906
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1505 BLANDING ST
Second Line :
City : COLUMBIA
State : SC
Zip : 29201-2906
Country : US
Telephone Number : 803-929-0011
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/20/2026
Last Update Date : 03/20/2026

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Directions to “ ALYSSA NADEAU ” Practice Location

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