Individual
JOSH HEFFERNAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
644 TALLULAH TRL, WARNER ROBINS, GA 31088-7625
(478) 225-2179
(478) 352-0098
Mailing address
1425 POPLAR OAKS TRL, MONROE, GA 30655-7358
(404) 993-4253
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
21159950
GA
Other
Enumeration date
03/18/2021
Last updated
04/02/2021
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