Individual
MRS. EARLISSA BOURNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6100 VETERANS PKWY STE 11, COLUMBUS, GA 31909-3514
(706) 221-8966
Mailing address
6100 VETERANS PKWY STE 11, COLUMBUS, GA 31909-3514
(706) 221-8966
(706) 221-8967
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
GA
106S00000X
Behavior Technician
—
—
Other
Enumeration date
03/26/2021
Last updated
11/26/2025
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