Individual
EBONY MASON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3675 CRESTWOOD PKWY NW STE 472, DULUTH, GA 30096-5136
(404) 563-5682
Mailing address
3675 CRESTWOOD PKWY NW STE 472, DULUTH, GA 30096-5136
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
09/23/2020
Last updated
06/10/2021
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