| NPI | 1861201634 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REBECCA ROSS Credentialing 678-894-1116 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst |
| Additional Taxonomies | 103T00000X Psychologist |
| Enumeration Date | 2025-01-06 |
| Last Update Date | 2025-01-06 |