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1073368965
MIQUIA LIDE
LAWRENCEVILLE, GA
NPI
1073368965
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
106S00000X Behavior Technician
(Licence: GA RBT-24-339377)
Enumeration Date
2024-04-23
Last Update Date
2024-04-23
Business Address
MIQUIA LIDE
2387 HUNTCREST WAY
LAWRENCEVILLE, GA 30043-8126
Phone number: 678-648-7644
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Mailing Address
MIQUIA LIDE
6505 SHILOH RD STE 100
ALPHARETTA, GA 30005-1645
Phone number: 678-648-7644
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