| NPI | 1740813088 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REBECCA ROSS Credentialing Coordinator 678-894-1116 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst |
| Additional Taxonomies | 103T00000X Psychologist |
| Enumeration Date | 2020-02-14 |
| Last Update Date | 2024-06-26 |