Individual
ABDUL SHABAZZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
11660 ALPHARETTA HWY STE 320, ROSWELL, GA 30076-3878
(678) 608-2543
Mailing address
1824 OLD DOGWOOD, JONESBORO, GA 30238-7515
(843) 302-2419
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
08/06/2019
Last updated
01/20/2021
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