Provider Demographics
NPI:1376296095
Name:DA SILVA, STEPHANIE PLYLER (MA, BCBA-D, PHD)
Entity Type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:PLYLER
Last Name:DA SILVA
Suffix:
Gender:F
Credentials:MA, BCBA-D, PHD
Other - Prefix:DR
Other - First Name:STEPHANIE
Other - Middle Name:PLYLER
Other - Last Name:THIEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BCBA-D
Mailing Address - Street 1:3409 PONTIAC DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31907-2053
Mailing Address - Country:US
Mailing Address - Phone:706-905-9263
Mailing Address - Fax:
Practice Address - Street 1:3409 PONTIAC DR
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31907-2053
Practice Address - Country:US
Practice Address - Phone:706-905-9263
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-02
Last Update Date:2022-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician