Individual
ANTHONY HAIRSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RBT
Contact information
Practice address
1990 SURREY TRL, ATLANTA, GA 30349-3822
(678) 643-0252
Mailing address
1990 SURREY TRL, ATLANTA, GA 30349-3822
(678) 643-0252
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-24-322337
GA
Other
Enumeration date
03/25/2024
Last updated
03/25/2024
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