Individual
SHAICIMAH GANT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
26 WAVERLY DR, APT H, STROUDSBURG, PA 18360-1418
(973) 220-3650
Mailing address
100 LESLIE OAK DRIVE, APT 12202, LITHONIA, GA 30058
(229) 462-4544
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
10/26/2016
Last updated
06/30/2017
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