Individual
ILLYCIA SHIRLEY RHULE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
602 VICTORIA PL STE A, THOMASVILLE, GA 31792-6687
(800) 832-9419
(855) 859-1671
Mailing address
3121 N OAK STREET EXT, VALDOSTA, GA 31602-1099
(800) 832-9419
(855) 859-1671
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
19-108969
GA
Other
Enumeration date
01/10/2020
Last updated
01/24/2024
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