Individual
JADEN PEREZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5072 LAVISTA RD, TUCKER, GA 30084-3500
(706) 842-5330
(706) 842-5340
Mailing address
PO BOX 2567, AUGUSTA, GA 30903-2567
(706) 842-5330
(706) 842-5340
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-23-284101
GA
Other
Enumeration date
07/12/2023
Last updated
07/12/2023
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