Provider Demographics
NPI:1891300976
Name:PLANNETTE, MILES CHRISTIAN (BCBA)
Entity type:Individual
Prefix:
First Name:MILES
Middle Name:CHRISTIAN
Last Name:PLANNETTE
Suffix:
Gender:M
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:53 WINNACUNNET RD
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:NH
Mailing Address - Zip Code:03842-2122
Mailing Address - Country:US
Mailing Address - Phone:603-926-8706
Mailing Address - Fax:
Practice Address - Street 1:53 WINNACUNNET RD
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:NH
Practice Address - Zip Code:03842-2110
Practice Address - Country:US
Practice Address - Phone:603-926-8706
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-15
Last Update Date:2020-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1-20-41619103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst