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Individual

EQUENCE NICOLE BYNUM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MED, BCBA

Contact information

Practice address
650 FULLIER CIR SW, ATLANTA, GA 30331-7993
(404) 664-9406
Mailing address
650 FULLIER CIR SW, ATLANTA, GA 30331-7993

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-23-65191
GA

Other

Enumeration date
04/19/2023
Last updated
04/19/2023
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