Provider Demographics
NPI:1720315450
Name:ARNOLD, MICHAEL (BCBA)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:
Last Name:ARNOLD
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 1:114 KIRTON TURN
Mailing Address - Street 2:
Mailing Address - City:PEACHTREE CITY
Mailing Address - State:GA
Mailing Address - Zip Code:30269-2422
Mailing Address - Country:US
Mailing Address - Phone:770-310-9893
Mailing Address - Fax:770-487-2470
Practice Address - Street 1:114 KIRTON TURN
Practice Address - Street 2:
Practice Address - City:PEACHTREE CITY
Practice Address - State:GA
Practice Address - Zip Code:30269-2422
Practice Address - Country:US
Practice Address - Phone:770-310-9893
Practice Address - Fax:770-487-2470
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-18
Last Update Date:2009-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1-02-0918103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst