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Individual

CARLY MICHELLE ETHRIDGE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
2751 WARM SPRINGS RD, COLUMBUS, GA 31904-6858
(705) 786-1110
Mailing address
2751 WARM SPRINGS RD, COLUMBUS, GA 31904-6858

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
GA

Other

Enumeration date
06/04/2026
Last updated
06/04/2026
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