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Individual

HAILEY BLACKSTOCK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
BCBA

Contact information

Practice address
1389 WEBER INDUSTRIAL DR, CUMMING, GA 30041-6468
(770) 886-6204
(678) 261-6421
Mailing address
352 MILL COVE DR, DAHLONEGA, GA 30533-7617

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-17-26951
GA

Other

Enumeration date
09/27/2017
Last updated
09/27/2017
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