Individual
MRS. ANGELA M GRAVES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3229 S CHEROKEE LN STE 1400, WOODSTOCK, GA 30188
(470) 499-2482
Mailing address
3229 S CHEROKEE LN STE 1400, WOODSTOCK, GA 30188-4461
(470) 499-2482
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
ABA-IN-10193688
OR
106S00000X
Behavior Technician
Primary
RBT-19-91959
GA
Other
Enumeration date
03/13/2019
Last updated
07/17/2019
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