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NPI Code Detail

MEDICARE: ALYSSA NICOLE ARCHIE

MEDICARE: ALYSSA NICOLE ARCHIE
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 Analyst

General Provider Information

NPI Number : 1891383089
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALYSSA NICOLE ARCHIE
Provider Business Mailing Address
First Line : 300 INTERNATIONAL PKWY STE 200
Second Line :
City : LAKE MARY
State : FL
Zip : 32746-3625
Country : US
Telephone Number : 484-467-2729
Fax Number :
Provider Business Practice Location Address
First Line : 60 PEACHTREE STREET NW
Second Line : SUITE 2200
City : ATLANTA
State : GA
Zip : 30303-1292
Country : US
Telephone Number : 855-832-6727
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/04/2021
Last Update Date : 12/09/2025

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Directions to “ ALYSSA NICOLE ARCHIE ” Practice Location

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