Individual
CRAIG SHANNON WATERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
7360 MCGINNIS FERRY RD STE 100, JOHNS CREEK, GA 30024-7810
(866) 523-4268
Mailing address
DEPT LA 22763, PASADENA, CA 91185-4268
(866) 523-4268
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
08/16/2022
Last updated
08/16/2022
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