Individual
ANTONESHA LATRICE YOUNGBLOOD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
X
Contact information
Practice address
7249 MOUNTAIN LAUREL WAY, STOCKBRIDGE, GA 30281-9312
(404) 397-8773
Mailing address
7249 MOUNTAIN LAUREL WAY, STOCKBRIDGE, GA 30281-9312
(404) 397-8773
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
05/27/2025
Last updated
05/27/2025
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