Organization
BEHAVIOR MOMENTUM LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER MICHELLE DETHERAGE (BCBA)
(706) 676-6689
Entity
Organization
Contact information
Practice address
113 ACADIA DR NW, ROME, GA 30165-1850
(706) 676-6689
Mailing address
113 ACADIA DR NW, ROME, GA 30165-1850
(706) 676-6689
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
02/09/2023
Last updated
02/09/2023
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