Provider Demographics
NPI:1518584390
Name:SICKO, MEREDITH (BCBA)
Entity Type:Individual
Prefix:
First Name:MEREDITH
Middle Name:
Last Name:SICKO
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 MCKENNA COMMONS CT
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29615-2633
Mailing Address - Country:US
Mailing Address - Phone:864-509-1555
Mailing Address - Fax:
Practice Address - Street 1:7 MCKENNA COMMONS CT
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29615-2633
Practice Address - Country:US
Practice Address - Phone:864-509-1555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-29
Last Update Date:2020-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst