Individual
MRS. ABBY BANNISTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
316 W 10TH ST NE, ROME, GA 30165-2639
(800) 844-1232
Mailing address
980 COUNTY ROAD 91, GAYLESVILLE, AL 35973
(256) 484-1097
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
0-22-13950
GA
103K00000X
Behavior Analyst
Primary
1-23-64203
—
Other
Enumeration date
09/22/2022
Last updated
02/20/2023
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