Individual
JANA GILLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1135 SENOIA RD, TYRONE, GA 30290-1625
(770) 626-3044
Mailing address
1135 SENOIA RD, TYRONE, GA 30290-1625
(770) 626-3044
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-23-302522
GA
Other
Enumeration date
10/09/2023
Last updated
10/09/2023
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