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Organization
BECKHOM BEHAVIORAL CONSULTING, LLC
Active
Organization
BECKHOM BEHAVIORAL CONSULTING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KATRINA MICHELLE WILBURN-BECKHOM BCBA (PROGRAM DIRECTOR)
(229) 439-9951
Entity
Organization
Contact information
Practice address
1509 W 3RD AVE, ALBANY, GA 31707-3647
(229) 439-9951
(229) 439-9553
Mailing address
PO BOX 51293, ALBANY, GA 31703-1293
(229) 439-9951
(229) 439-9553
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-03-1465
—
106E00000X
Assistant Behavior Analyst
—
—
106S00000X
Behavior Technician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003179879B
—
GA
05
—
003179879C
—
GA
05
—
003183174A
—
GA
Enumeration date
08/04/2017
Last updated
08/04/2017
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