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1922887884
LOGAN SHAW-JERNIGAN
CONYERS, GA
NPI
1922887884
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
106S00000X Behavior Technician
(Licence: GA RBT-23-268775)
Enumeration Date
2023-09-28
Last Update Date
2023-09-28
Business Address
LOGAN SHAW-JERNIGAN RBT
2415 WALL ST SE
CONYERS, GA 30013-6384
Phone number: 470-207-8845
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Mailing Address
LOGAN SHAW-JERNIGAN RBT
3500 DEPAUW BLVD STE 3070
INDIANAPOLIS, IN 46268-6135
Phone number: 855-324-0885
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