Individual
DEJA GRANGENT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1130 HILBURN DR SE, ATLANTA, GA 30316-2811
(404) 243-3167
Mailing address
1130 HILBURN DR SE, ATLANTA, GA 30316-2811
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
06/03/2022
Last updated
06/03/2022
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