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1902518145
BETHANY SHAW
EVANS, GA
NPI
1902518145
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
106S00000X Behavior Technician
(Licence: GA 22-250099)
Enumeration Date
2022-12-20
Last Update Date
2022-12-20
Business Address
BETHANY SHAW RBT
624 PONDER PLACE DR
EVANS, GA 30809-3343
Phone number: 706-863-9699
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Mailing Address
BETHANY SHAW RBT
10175 FORTUNE PKWY UNIT 903
JACKSONVILLE, FL 32256-6755
Phone number: 904-538-0713
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