| Sds Behavioral Consulting Llc | |
|
194 Cypress Forest Dr Moncks Corner SC 29461-8441 | |
| (803) 459-8022 | |
| (803) 845-3510 |
| Full Name | Sds Behavioral Consulting Llc |
|---|---|
| Speciality | Behavior Analyst |
| Location | 194 Cypress Forest Dr, Moncks Corner, South Carolina |
| Authorized Official Name and Position | Stacie Dizzley-streeter (OWNER) |
| Authorized Official Contact | 8034598022 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sds Behavioral Consulting Llc 194 Cypress Forest Dr Moncks Corner SC 29461-8441 Ph: (803) 459-8022 | Sds Behavioral Consulting Llc 194 Cypress Forest Dr Moncks Corner SC 29461-8441 Ph: (803) 459-8022 |
| NPI Number | 1184346066 |
|---|---|
| Provider Enumeration Date | 09/16/2022 |
| Last Update Date | 01/25/2023 |
| Certification Date | 01/25/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184346066 | NPI | - | NPPES |
| BA1197 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
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