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

LicenseStateTypeSpecialty
RBT-25-431026GAMDBehavioral Analyst

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst
Group: 193400000X SINGLE SPECIALTY GROUP
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

Other providers in Stone Mountain, GA

All providers in Stone Mountain, GA · Behavior Analyst in Georgia

Sources for this page

Verify at the official NPI Registry.