Individual
TASHA ROYAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2601 BEMISS RD STE Q, VALDOSTA, GA 31602-1450
(229) 809-0893
Mailing address
105 ROYALS RD, LAKELAND, GA 31635-6311
(229) 415-4344
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-25-82734
GA
106S00000X
Behavior Technician
RBT-21-197792
GA
Other
Enumeration date
12/24/2021
Last updated
07/28/2025
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