Individual
KEERTHANA SIVARAMAKRISHNAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
1664 MARKET PLACE BLVD, CUMMING, GA 30041-7927
(470) 253-4121
Mailing address
300 INTERNATIONAL PKWY STE 200, LAKE MARY, FL 32746-5028
(470) 253-4121
(470) 588-6294
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-24-76291
GA
Other
Enumeration date
11/12/2021
Last updated
10/17/2024
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