Provider Demographics
NPI:1124839428
Name:DUNCAN, DENISE M (BCBA)
Entity type:Individual
Prefix:
First Name:DENISE
Middle Name:M
Last Name:DUNCAN
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 1:3480 LONG LAKE DR
Mailing Address - Street 2:
Mailing Address - City:DOUGLASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30135-7620
Mailing Address - Country:US
Mailing Address - Phone:909-718-9138
Mailing Address - Fax:
Practice Address - Street 1:5829 CAMPBELLTON RD SW
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30331-8037
Practice Address - Country:US
Practice Address - Phone:770-940-0237
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-15
Last Update Date:2025-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA1-22-62698103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty