Individual provider · NPI-1

Theresa Lynn Wade

Behavior Analyst · Dublin, GA

NPI number1003795030
StatusActive
Last updated in NPPESSep 2, 2025

Details

NPI
1003795030
Entity type
Individual (NPI-1)
Name
Theresa Lynn Wade
Sex
Female
Sole proprietor
No
Enumeration date
Sep 2, 2025
Certification date
Sep 2, 2025
Last updated
Sep 2, 2025

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
103K00000X Behavior Analyst––Yes

Practice location

1606 S Jefferson St Apt F8
Dublin, GA 31021-3188

Phone 478-278-0409

Mailing address

1606 S Jefferson St Apt F8
Dublin, GA 31021-3188

Phone 478-278-0409

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