Individual
HANNAH JODAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
382 RACETRACK RD, MCDONOUGH, GA 30252-1022
(678) 691-2206
Mailing address
382 RACETRACK RD STE A, MCDONOUGH, GA 30252-1022
(678) 691-2206
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-21-161791
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RBT-21-161791
RBT
GA
Enumeration date
07/15/2021
Last updated
07/15/2021
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