Individual
CORY CLAYTON SHATTLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RBT
Contact information
Practice address
104 E GORDON ST, VILLA RICA, GA 30180-2018
(229) 366-1687
Mailing address
104 E GORDON ST, VILLA RICA, GA 30180-2018
(229) 366-1687
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-21-171519
GA
106S00000X
Behavior Technician
RBT-21-171519
—
Other
Enumeration date
06/14/2021
Last updated
08/19/2024
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