Provider Demographics
NPI:1578912739
Name:GANDHI, PAAYAL
Entity Type:Individual
Prefix:
First Name:PAAYAL
Middle Name:
Last Name:GANDHI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:382 RACETRACK RD
Mailing Address - Street 2:
Mailing Address - City:MCDONOUGH
Mailing Address - State:GA
Mailing Address - Zip Code:30252-1022
Mailing Address - Country:US
Mailing Address - Phone:678-691-2206
Mailing Address - Fax:
Practice Address - Street 1:1450 54TH ST STE C
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31904-4494
Practice Address - Country:US
Practice Address - Phone:706-221-1208
Practice Address - Fax:904-538-0714
Is Sole Proprietor?:No
Enumeration Date:2016-06-08
Last Update Date:2021-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RBT-16-18481106S00000X
GA1-20-41568103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician