Individual
CARTERIA RICHARDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3100 FIVE FORKS TRICKUM RD SW, LILBURN, GA 30047-1890
(470) 485-2220
Mailing address
3100 FIVE FORKS TRICKUM RD SW, LILBURN, GA 30047-1890
(470) 485-2220
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
GA
106S00000X
Behavior Technician
—
—
Other
Enumeration date
12/07/2023
Last updated
05/09/2024
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