Individual
DESTINEY LAMORE HEARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
90 NELLIE BROOK DR SW, MABLETON, GA 30126-4435
(912) 224-2375
Mailing address
90 NELLIE BROOK DR SW, MABLETON, GA 30126-4435
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
06/12/2024
Last updated
06/12/2024
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