Individual
MS. JAMIE GUADALUPE MARGARITO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NONE
Contact information
Practice address
4990 LAKE FIELD DR, DOUGLASVILLE, GA 30135-7671
(404) 807-1562
(000) 000-0000
Mailing address
4990 LAKE FIELD DR, DOUGLASVILLE, GA 30135-7671
(404) 807-1562
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
061289895
DRIVER LICENSE
GA
Enumeration date
01/11/2023
Last updated
01/11/2023
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