Individual
CHAZARE RILEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
72 DRAYTON CT, MIDWAY, GA 31320-7142
(404) 697-3608
Mailing address
72 DRAYTON CT, MIDWAY, GA 31320-7142
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-22-218809
GA
Other
Enumeration date
06/06/2022
Last updated
06/06/2022
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