1376296095 NPI number — DR. STEPHANIE PLYLER DA SILVA MA, BCBA-D, PHD

Table of content: DR. STEPHANIE PLYLER DA SILVA MA, BCBA-D, PHD (NPI 1376296095)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1376296095 NPI number — DR. STEPHANIE PLYLER DA SILVA MA, BCBA-D, PHD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DA SILVA
Provider First Name:
STEPHANIE
Provider Middle Name:
PLYLER
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MA, BCBA-D, PHD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
THIEL
Provider Other First Name:
STEPHANIE
Provider Other Middle Name:
PLYLER
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
BCBA-D
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1376296095
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/02/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3409 PONTIAC DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
COLUMBUS
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
31907-2053
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
706-905-9263
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3409 PONTIAC DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
COLUMBUS
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
31907-2053
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
706-905-9263
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/02/2022

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 106S00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 103K00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com