Andrea Dawn Speece, BCBA, COBA

Individual provider Active NPI Behavior Analyst · Huntsburg, OH

NPI 1831786243 · NPPES record last updated Dec 31, 2020

Key facts

NPI
1831786243
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Analyst 103K00000X
License
225 (OH)
Practice address
15445 Chardon Windsor Rd
Huntsburg, OH 44046-8728
Phone
(440) 313-8636
NPI assigned
Dec 31, 2020
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

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
225OHMDBehavioral Analyst

Practice roles

OrganizationSpecialtyStatusNew patients
Proactive Behavior Therapy, LLC Behavior Analyst Current
since Jan 3, 2021
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 225 OH Yes

Addresses

Primary practice location

15445 Chardon Windsor Rd
Huntsburg, OH 44046-8728

Mailing address

4820 S Duck Creek Rd
North Jackson, OH 44451-9736
Phone (330) 718-2693

Other providers in Huntsburg, OH

All providers in Huntsburg, OH · Behavior Analyst in Ohio

Sources for this page

Verify at the official NPI Registry.