Individual
AMIA CROCKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7777 TARA RD, JONESBORO, GA 30236-2316
(770) 800-5655
Mailing address
7777 TARA RD, JONESBORO, GA 30236-2316
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
GA
Other
Enumeration date
07/27/2026
Last updated
07/27/2026
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