Individual
GEORGINA CULLEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
32 W MAIN ST, LAKELAND, GA 31635-6835
(800) 832-9419
Mailing address
3121 N OAK STREET EXT, VALDOSTA, GA 31602-1099
(800) 832-9419
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
04/01/2024
Last updated
04/01/2024
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