Individual
ANNADALE MARIE ROBERTS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3316 BEMISS RD, VALDOSTA, GA 31605-7014
(352) 284-6057
Mailing address
543 JAMAR TRL, QUITMAN, GA 31643-5834
(229) 456-7403
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-22-221216
GA
Other
Enumeration date
05/28/2025
Last updated
05/28/2025
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