Individual
ALEXIS MARIE HISHAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2810 PREMIERE PKWY STE 500, DULUTH, GA 30097-8912
(404) 453-5099
Mailing address
3425 COFFEE RD STE C2, MODESTO, CA 95355-1582
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
09/15/2020
Last updated
09/15/2020
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