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Individual

DIAMOND WHITE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
125 EAGLES WALK STE 250, STOCKBRIDGE, GA 30281-7249
(478) 471-9195
Mailing address
3450 BLAIR CIR NE UNIT 4209, BROOKHAVEN, GA 30319-2266
(478) 471-9195

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
222Q00000X
Developmental Therapist

Other

Enumeration date
09/18/2019
Last updated
09/18/2019
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