Individual
BRIANNA CROCKETT I
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3121 N OAK STREET EXT, VALDOSTA, GA 31602-1099
(800) 832-9419
Mailing address
3121 N OAK STREET EXT, VALDOSTA, GA 31602-1099
(800) 832-9419
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
RBT-23-275500
GA
Other
Enumeration date
06/15/2023
Last updated
06/15/2023
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