Carolyn K Broner, BCBA
Individual provider Active NPI Behavior Analyst · Suwanee, GA
NPI 1326600446 · NPPES record last updated Jan 24, 2022
Key facts
- NPI
- 1326600446
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Analyst 103K00000X
- License
- 1-19-36380
- Practice address
- 2930 Horizon Park Dr Ste D
Suwanee, GA 30024-7252 - Phone
- (770) 462-8550
- Fax
- (470) 322-4355
- NPI assigned
- Jun 29, 2019
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Applied Behavioral Approaches | Behavior Analyst | Current |
Accepting new patients |
| Applied Behavioral Approaches | Behavior Analyst | Current |
Accepting new patients |
Locations
2930 Horizon Park Dr
Ste D
Suwanee, GA 30024
Phone (770) 462-8550
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 1-19-36380 | Yes |
Addresses
Primary practice location
2930 Horizon Park Dr Ste D
Suwanee, GA 30024-7252
Mailing address
2339 Meadow Peak PT
Duluth, GA 30097-4366
Phone (313) 320-4530
Other providers in Suwanee, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 24, 2022. 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.