# SOUTH GEORGIA BEHAVIOR ASSOCIATES

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1992308605
- **Authorized official:** SUMMER MARIA MINGO BCBA (CO-OWNER, BCBA,)
- **Authorized official phone:** (850) 345-8336

## Contact information

- **Practice address:** 113 SOUTHSIDE DR, NASHVILLE, GA 31639
- **Practice address phone:** (850) 345-8336
- **Mailing address:** 113 SOUTHSIDE DR, NASHVILLE, GA 31639
- **Mailing address phone:** (850) 345-8336

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 103K00000X | Behavior Analyst | — | NULL | Yes |
| 103K00000X | Behavior Analyst | — | — | Yes |

## Other

- **Enumeration date:** 11/17/2020
- **Last updated:** 11/17/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 003204507A | — | GA |
| 05 | — | 003277334A | — | GA |