Individual
DESTANEE ATWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7013 EVANS TOWN CENTER BLVD STE 401, EVANS, GA 30809-4317
(706) 842-5330
(706) 842-5340
Mailing address
PO BOX 2567, AUGUSTA, GA 30903-2567
(706) 842-5330
(706) 842-5340
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-23-275533
GA
Other
Enumeration date
05/25/2023
Last updated
05/25/2023
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