Individual
ALYSSA L SWANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
26121 US ROUTE 11 STE 1, EVANS MILLS, NY 13637-3283
(315) 221-5201
Mailing address
2225 BEMISS RD STE D, VALDOSTA, GA 31602-4819
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-22-241460
GA
Other
Enumeration date
11/03/2022
Last updated
08/29/2024
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