Individual
ISAIAH HAXTON PREVATT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
100 SPENRYN DR, MADISON, AL 35758-1890
(256) 772-4400
Mailing address
100 SPENRYN DR, MADISON, AL 35758-1890
(256) 772-4400
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
25-412369
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
25-412369
25-412369
—
Enumeration date
02/25/2025
Last updated
02/25/2025
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