Individual
GEORGIA HALE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2709 VICTORIA DR, PICAYUNE, MS 39466-4953
(504) 473-8629
Mailing address
2709 VICTORIA DR, PICAYUNE, MS 39466-4953
(504) 473-8629
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
04/03/2017
Last updated
04/03/2017
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