Organization Name: | BEHAVIORAL INNOVATIONS, LLC |
NPI Number: | 1720380801 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | PATRICIA DUNSHA (OWNER) |
Mailing Address: | 551 N Cherokee Rd Social Circle |
State: | GA US |
Postal Code: | 300252887 |
Phone Number: | 7708258124 |
Fax Number: | 7708259066 |
NPI Enumeration Date: | 11/23/2010 |
NPI Last Update Date: | 11/23/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | LPC005661 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |