Individual
ANDREISY MAILLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MED
Contact information
Practice address
1921 WHITTLESEY RD STE 400, COLUMBUS, GA 31904-9211
(706) 229-9629
(706) 243-6497
Mailing address
1921 WHITTLESEY RD STE 400, COLUMBUS, GA 31904-9211
(706) 221-9629
(706) 243-6497
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-19-39689
AL
106S00000X
Behavior Technician
RBT-15-07315
GA
Other
Enumeration date
07/01/2015
Last updated
05/04/2020
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