Individual
HEZEKIAH TYAUN ROSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
680 THORNTON WAY, LITHIA SPRINGS, GA 30122-2600
(888) 329-4535
Mailing address
3000 HIGHWAY 5 APT 109, DOUGLASVILLE, GA 30135-6903
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
GA
Other
Enumeration date
12/16/2025
Last updated
12/16/2025
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