Individual provider · NPI-1

Corey Blagsvedt, RBT

Behavior Analyst · Charleston, SC

NPI number1356913438
StatusActive
Last updated in NPPESJul 16, 2021

Details

NPI
1356913438
Entity type
Individual (NPI-1)
Name
Corey Blagsvedt
Credential
RBT
Sex
Male
Sole proprietor
Yes
Enumeration date
Jul 16, 2021
Certification date
Jun 10, 2021
Last updated
Jul 16, 2021

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
103K00000X Behavior Analyst17-38371SCYes

Practice location

2413 Savannah Hwy
Charleston, SC 29414-5323

Phone 843-449-0554

Mailing address

1508 Azalea Dr, Myrtle Beach
Myrtle Beach, Sc, SC 29575

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