Individual
MAKAYLA HERRERA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2462 HIGHWAY 34 E STE E, NEWNAN, GA 30265-2378
(770) 580-3057
Mailing address
6100 VETERANS PKWY STE 11, COLUMBUS, GA 31909-3514
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
16-22148
GA
225100000X
Physical Therapist
Primary
PT017348
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
071423
CPH
GA
Enumeration date
01/15/2018
Last updated
12/10/2024
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