Individual
TASHAI SHELBY BRANTLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3655 HOWELL FERRY RD STE 400, DULUTH, GA 30096-3186
(770) 373-5822
(248) 712-4381
Mailing address
3655 HOWELL FERRY RD STE 400, DULUTH, GA 30096-3186
(770) 373-5822
(248) 712-4381
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
—
156F00000X
Technician/Technologist
Primary
—
—
Other
Enumeration date
09/30/2020
Last updated
05/02/2022
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