Individual
MRS. AMBER RAE TEAGUE TRAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.ED., BCBA
Contact information
Practice address
6 PELHAM RIDGE DR, GREENVILLE, SC 29615-5935
(803) 530-0674
Mailing address
6 PELHAM RIDGE DR, GREENVILLE, SC 29615-5935
(803) 530-0674
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
11518217
SC
Other
Enumeration date
04/13/2015
Last updated
06/17/2016
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