Individual
VIDISHA GANGIDI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
4335 STEVE REYNOLDS BLVD, NORCROSS, GA 30093-3362
(770) 674-5797
(770) 864-5338
Mailing address
815 PARK NORTH BLVD, CLARKSTON, GA 30021-6200
(404) 943-1070
(404) 943-0890
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-24-76150
GA
Other
Enumeration date
11/05/2020
Last updated
03/17/2025
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