Individual
KALI BRUX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3766 US HIGHWAY 17 STE 301, RICHMOND HILL, GA 31324-8876
(912) 445-2344
(904) 538-0714
Mailing address
10175 FORTUNE PKWY UNIT 903, JACKSONVILLE, FL 32256-6755
(904) 538-0713
(904) 538-0714
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-22-62589
GA
106S00000X
Behavior Technician
RBT-19-96760
GA
Other
Enumeration date
08/22/2019
Last updated
03/01/2023
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