Provider Demographics
NPI:1871045591
Name:PEASLEE, AUSTIN (BCBA)
Entity Type:Individual
Prefix:
First Name:AUSTIN
Middle Name:
Last Name:PEASLEE
Suffix:
Gender:M
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 EAST PARK
Mailing Address - Street 2:
Mailing Address - City:ANACONDA
Mailing Address - State:MT
Mailing Address - Zip Code:59711
Mailing Address - Country:US
Mailing Address - Phone:406-563-8117
Mailing Address - Fax:406-563-5956
Practice Address - Street 1:205 EAST PARK
Practice Address - Street 2:
Practice Address - City:ANACONDA
Practice Address - State:MT
Practice Address - Zip Code:59711
Practice Address - Country:US
Practice Address - Phone:406-563-8117
Practice Address - Fax:406-563-5956
Is Sole Proprietor?:No
Enumeration Date:2016-10-28
Last Update Date:2016-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst