Provider Demographics
NPI:1629461405
Name:SPECTRUM ANALYTIC CONSULTING LLC
Entity type:Organization
Organization Name:SPECTRUM ANALYTIC CONSULTING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KRISTEN
Authorized Official - Middle Name:
Authorized Official - Last Name:BUSH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-974-2162
Mailing Address - Street 1:PO BOX 76094
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30358
Mailing Address - Country:US
Mailing Address - Phone:678-974-2162
Mailing Address - Fax:888-533-9896
Practice Address - Street 1:750 HAMMOND DR NE
Practice Address - Street 2:BLDG 16 STE 100
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30328-6144
Practice Address - Country:US
Practice Address - Phone:678-974-2162
Practice Address - Fax:888-533-9896
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-18
Last Update Date:2024-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty