Provider Demographics
NPI:1619637147
Name:I PEEP BXS
Entity Type:Organization
Organization Name:I PEEP BXS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BOARD CERTIFIED BEHAVIOR ANALYST
Authorized Official - Prefix:
Authorized Official - First Name:DONTA
Authorized Official - Middle Name:
Authorized Official - Last Name:HALLMON
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:762-622-8360
Mailing Address - Street 1:PO BOX 19525
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30325-0525
Mailing Address - Country:US
Mailing Address - Phone:762-622-8360
Mailing Address - Fax:888-720-3196
Practice Address - Street 1:756 W PEACHTREE ST NW FL 4
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30308-2378
Practice Address - Country:US
Practice Address - Phone:762-622-8360
Practice Address - Fax:888-720-3196
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-23
Last Update Date:2023-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty