Provider Demographics
NPI:1003216789
Name:PRIME BEHAVIOR ANALYSTS, LLC
Entity Type:Organization
Organization Name:PRIME BEHAVIOR ANALYSTS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BEHAVIOR ANALYST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MEAGHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:TIMKO
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:404-695-3596
Mailing Address - Street 1:PO BOX 126
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30061-0126
Mailing Address - Country:US
Mailing Address - Phone:404-695-3596
Mailing Address - Fax:404-935-5335
Practice Address - Street 1:376 POWDER SPRINGS ST
Practice Address - Street 2:SUITE 130
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30064-3454
Practice Address - Country:US
Practice Address - Phone:404-695-3596
Practice Address - Fax:404-935-5335
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-29
Last Update Date:2014-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1-05-2608103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty