Individual
DONIVAN VINCEST DANIEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5328 LANIER ISLANDS PKWY UNIT 101, BUFORD, GA 30518-9071
(470) 655-1970
Mailing address
5328 LANIER ISLANDS PKWY UNIT 101, BUFORD, GA 30518-9071
(470) 655-1970
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
03/09/2023
Last updated
03/09/2023
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