Individual
MS. KANISHA NICOLE EBERHARDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
QASP-S
Contact information
Practice address
3633 WHEELER RD STE 320, AUGUSTA, GA 30909-6552
(706) 842-3279
Mailing address
3633 WHEELER RD STE 320, AUGUSTA, GA 30909-6552
(706) 842-3279
Taxonomy
Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
Primary
11343
—
247200000X
Other Technician
RBT-20-119073
GA
Other
Enumeration date
07/07/2021
Last updated
11/07/2023
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