Individual
ANITA FERGUSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
207 UPPER RIVERDALE RD SW, RIVERDALE, GA 30274-2585
(470) 944-1039
Mailing address
206 ROXBURY DR, RIVERDALE, GA 30274-2707
(216) 905-8399
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
04/24/2024
Last updated
04/24/2024
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