Individual
ABBIGALE CLARE DEHART
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
131 MUSTANG RD, SOPERTON, GA 30457-7461
(478) 331-8460
Mailing address
131 MUSTANG RD, SOPERTON, GA 30457-7461
(478) 331-8460
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
BACB1182292
GA
Other
Enumeration date
02/25/2025
Last updated
02/25/2025
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