Dominick John Anziano II
Individual provider Active NPI Behavior Analyst · Stone Mountain, GA
NPI 1013877844 · NPPES record last updated Nov 14, 2025
Key facts
- NPI
- 1013877844
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Analyst 103K00000X
- License
- RBT-25-431026 (GA)
- Practice address
- 740 Stoneside CT
Stone Mountain, GA 30083-6002 - Phone
- (404) 668-7324
- NPI assigned
- Nov 14, 2025
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RBT-25-431026 | GA | MD | Behavioral Analyst |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst |
103K00000X | RBT-25-431026 | GA | Yes |
Addresses
Primary practice location
740 Stoneside CT
Stone Mountain, GA 30083-6002
Mailing address
740 Stoneside CT
Stone Mountain, GA 30083-6002
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- James H Arnold III
All providers in Stone Mountain, GA · Behavior Analyst in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 14, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.