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Individual

BRAXTON RAY ANDERSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
X

Contact information

Practice address
506 N MAIN ST, HINESVILLE, GA 31313-2512
(615) 241-0081
Mailing address
506 N, MAIN ST, HINESVILLE, GA 31313
(615) 241-0081

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
GA
106S00000X
Behavior Technician

Other

Enumeration date
06/23/2025
Last updated
06/23/2025
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