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Organization
SPECTRUM SUCCESS LLC
Active
Organization
SPECTRUM SUCCESS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
YAJURVANTHY CHEVALA (ORGANIZER)
(770) 790-7413
Entity
Organization
Contact information
Practice address
4300 WESTBROOK RD UNIT E, SUWANEE, GA 30024-4987
(770) 790-7413
Mailing address
3940 ESTATES PATH, CUMMING, GA 30040-1030
(201) 496-0525
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Enumeration date
04/02/2024
Last updated
04/04/2024
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