Individual
ADELAIDE MENDOZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PCE
Contact information
Practice address
3615 BRASELTON HWY STE 103, DACULA, GA 30019-5907
(678) 377-9634
(678) 377-9609
Mailing address
3615 BRASELTON HWY STE 103, DACULA, GA 30019-5907
(678) 377-9634
(678) 377-9609
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-21-189982
GA
235Z00000X
Speech-Language Pathologist
Primary
PCET004462
GA
Other
Enumeration date
10/29/2021
Last updated
04/17/2026
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