Individual
CHANEL L BISONO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3070 BUSINESS PARK DR STE B, NORCROSS, GA 30071-1428
(770) 884-1050
Mailing address
3070 BUSINESS PARK DR STE B, NORCROSS, GA 30071-1428
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
07/16/2021
Last updated
07/16/2021
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