Provider Demographics
NPI:1730570227
Name:CRITTENDEN, MEREDITH (BCBA)
Entity type:Individual
Prefix:
First Name:MEREDITH
Middle Name:
Last Name:CRITTENDEN
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:985 BRUTON CT SW
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30064-2971
Mailing Address - Country:US
Mailing Address - Phone:404-488-7811
Mailing Address - Fax:
Practice Address - Street 1:985 BRUTON CT SW
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30064-2971
Practice Address - Country:US
Practice Address - Phone:404-488-7811
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-05
Last Update Date:2021-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA1-14-17213103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst