Individual
DOMINIC STEPHAN PADGETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BCBA
Contact information
Practice address
5077 DALLAS HWY STE 301, POWDER SPRINGS, GA 30127-4510
(770) 763-8592
Mailing address
5077 DALLAS HWY STE 301, POWDER SPRINGS, GA 30127-4510
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-24-75018
GA
Other
Enumeration date
08/19/2024
Last updated
08/19/2024
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