Individual
AMANDA S HIGGINBOTHEM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RBT
Contact information
Practice address
175 WHITNEY RD, LEESBURG, GA 31763-3020
(229) 886-1677
Mailing address
457 ARMENA RD, LEESBURG, GA 31763-4228
(229) 343-2573
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
BACB647031
GA
Other
Enumeration date
05/07/2021
Last updated
05/07/2021
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