Individual
MRS. AMANDA GRACE RAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
360 N. MAIN STREET, 1A, HINESVILLE, GA 31313
(912) 294-4055
(866) 467-4321
Mailing address
306 NORTH MAIN STREET, 1A, HINESVILLE, GA 31313
(912) 924-4055
(866) 467-4321
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-19-96862
TX
106S00000X
Behavior Technician
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Other
Enumeration date
08/05/2019
Last updated
07/02/2021
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