Individual
ADIDASHEONNA SLOAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
110 PIPEMAKERS CIR STE 116, POOLER, GA 31322-4168
(912) 330-7171
(888) 413-4567
Mailing address
110 PIPEMAKERS CIR STE 116, POOLER, GA 31322-4168
(912) 330-7171
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-19-82782
GA
Other
Enumeration date
04/02/2019
Last updated
04/02/2019
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