Provider Demographics
NPI:1982231718
Name:VICTOR, SINDY (BCBA, LBA)
Entity Type:Individual
Prefix:
First Name:SINDY
Middle Name:
Last Name:VICTOR
Suffix:
Gender:F
Credentials:BCBA, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4854 OLD NATIONAL HWY STE 167
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30337-6201
Mailing Address - Country:US
Mailing Address - Phone:470-829-1333
Mailing Address - Fax:404-500-5983
Practice Address - Street 1:4854 OLD NATIONAL HWY STE 167
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30337-6201
Practice Address - Country:US
Practice Address - Phone:470-829-1333
Practice Address - Fax:404-500-5983
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-23
Last Update Date:2024-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT956103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty