Provider Demographics
NPI:1609522952
Name:SOAR BEHAVIOR ANALYSIS SERVICES
Entity Type:Organization
Organization Name:SOAR BEHAVIOR ANALYSIS SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, BCBA
Authorized Official - Prefix:
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:CHANDLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:334-202-8941
Mailing Address - Street 1:1200 LAKE CHARLES DR
Mailing Address - Street 2:
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30075-2829
Mailing Address - Country:US
Mailing Address - Phone:334-202-8941
Mailing Address - Fax:
Practice Address - Street 1:1200 LAKE CHARLES DR
Practice Address - Street 2:
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30075-2829
Practice Address - Country:US
Practice Address - Phone:334-202-8941
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-24
Last Update Date:2022-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty