Individual
BONNY MERRITT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
820 DUKE AVE STE A, WARNER ROBINS, GA 31093-2684
(478) 225-3880
Mailing address
PO BOX 931142, ATLANTA, GA 31193-1142
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-24-325137
GA
Other
Enumeration date
02/09/2024
Last updated
02/09/2024
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