Individual
JACQUELINE RICHARDSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2810 PREMIERE PKWY STE 500, DULUTH, GA 30097-8912
(866) 523-4268
Mailing address
1533 NAPIER TER, LAWRENCEVILLE, GA 30044-6093
(678) 789-6661
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
06/08/2022
Last updated
06/08/2022
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