Individual
FATIMA AYENI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
312 WASHINGTON ST, VIDALIA, GA 30474-4135
(912) 326-9031
Mailing address
312 WASHINGTON ST, VIDALIA, GA 30474-4135
(912) 326-9031
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-25-407994
GA
Other
Enumeration date
01/27/2025
Last updated
01/27/2025
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