Individual
MARA FELICE WHITE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
7465 HIGHTOWER CIR, CUMMING, GA 30028-3174
(215) 518-3709
Mailing address
7465 HIGHTOWER CIR, CUMMING, GA 30028-3174
(215) 518-3709
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-21-49657
GA
106S00000X
Behavior Technician
—
—
251S00000X
Community/Behavioral Health Agency
—
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003246117
—
GA
Enumeration date
12/16/2020
Last updated
06/15/2021
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