Organization
RADIANCE BEHAVIOR THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VICTORIA LADRONDEGUEVARA (OWNER)
(404) 480-8790
Entity
Organization
Contact information
Practice address
3901 MARY ELIZA TRCE NW STE 202, MARIETTA, GA 30064-1096
(470) 615-6277
Mailing address
3901 MARY ELIZA TRCE NW STE 202, MARIETTA, GA 30064-1096
(470) 615-6277
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
09/28/2023
Last updated
01/10/2024
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