Individual
LAIKA MIRTIL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
540 GLENN GEE RD APT 6205, PENDERGRASS, GA 30567-4728
(812) 850-0289
Mailing address
540 GLENN GEE RD APT 6205, PENDERGRASS, GA 30567-4728
(812) 850-0289
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-23-67979
GA
106S00000X
Behavior Technician
18-61416
IN
Other
Enumeration date
07/26/2021
Last updated
09/18/2023
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