Mishaya Bivins, RBT

Individual provider Active NPI Behavior Technician · Tyrone, GA

NPI 1285349449 · NPPES record last updated Jan 20, 2023

Key facts

NPI
1285349449
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
License
RBT-22-224891 (GA)
Practice address
190 Handley Rd
Tyrone, GA 30290-2178
Phone
(678) 904-7053
NPI assigned
Jan 20, 2023
Sex
Female
Sole proprietor
No

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-22-224891GAMDBehavior Technician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X RBT-22-224891 GA Yes

Addresses

Primary practice location

190 Handley Rd
Tyrone, GA 30290-2178

Mailing address

190 Handley Rd
Tyrone, GA 30290-2178
Phone (678) 904-7053

Other providers in Tyrone, GA

All providers in Tyrone, GA · Behavior Technician in Georgia

Sources for this page

Verify at the official NPI Registry.