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1548936339
DESTINEE JACK
SNELLVILLE, GA
NPI
1548936339
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
106S00000X Behavior Technician
(Licence: GA RBT-21-180344)
Enumeration Date
2021-08-20
Last Update Date
2021-08-20
Business Address
DESTINEE JACK RBT
2059 SCENIC HWY N STE 101
SNELLVILLE, GA 30078-6141
Phone number: 470-327-9193
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Mailing Address
DESTINEE JACK RBT
3500 DEPAUW BLVD STE 3070
INDIANAPOLIS, IN 46268-6135
Phone number: 855-324-0885
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