Individual
BIRDIE COLLYMORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4461 ASH TREE ST, SNELLVILLE, GA 30039-3357
(470) 363-1805
Mailing address
4461 ASH TREE ST, SNELLVILLE, GA 30039
(470) 363-1805
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
03/15/2017
Last updated
03/15/2017
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