Individual
MARISA AHTONEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1345 COMPANION CT, SUMTER, SC 29150-1749
(803) 905-5107
Mailing address
PO BOX 931142, ATLANTA, GA 31193-1142
(615) 247-5487
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-24-73250
—
106S00000X
Behavior Technician
—
—
Other
Enumeration date
04/25/2021
Last updated
07/02/2024
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