Individual
CASSANDRA SHORT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
919 REGENCY PATH DR, DECATUR, GA 30030-4168
(720) 333-6592
Mailing address
919 REGENCY PATH DR, DECATUR, GA 30030-4168
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-25-438001
GA
Other
Enumeration date
05/20/2025
Last updated
05/20/2025
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