Individual
GLORIA LYNN HENRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6190 THE LAKES DR, FAIRBURN, GA 30213-4615
(404) 452-9808
Mailing address
6190 THE LAKES DR, FAIRBURN, GA 30213-4615
(404) 452-9808
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
GA
Other
Enumeration date
06/27/2024
Last updated
06/27/2024
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