Individual
DETISHA BUNNICOLE TINSLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
175 GWINNETT DR, LAWRENCEVILLE, GA 30046-8444
(678) 209-2394
Mailing address
560 ALLENS LANDING CT, LAWRENCEVILLE, GA 30045-8852
(706) 530-7907
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
08/05/2021
Last updated
08/05/2021
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