EPHESIAN TISDALE

LAWRENCEVILLE, GA
NPI1659019834
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy106S00000X Behavior Technician
(Licence: GA  RBT-22-216818)
Enumeration Date2022-05-26
Last Update Date2024-05-20
Business Address
EPHESIAN TISDALE RBT
2387 HUNTCREST WAY
LAWRENCEVILLE, GA 30043-8126
Phone number: 678-648-7644
Mailing Address
EPHESIAN TISDALE RBT
6505 SHILOH RD STE 100
ALPHARETTA, GA 30005-1645
Phone number: 678-648-7644
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