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Individual

CHARLES T SMALLS JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
1170 PEACHTREE ST NE STE 1200, ATLANTA, GA 30309-7673
(646) 841-3962
Mailing address
8833 CHURCHILL PL, JONESBORO, GA 30238-4559
(404) 464-6924

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
106S00000X
Behavior Technician
GA
106S00000X
Behavior Technician

Other

Enumeration date
09/25/2019
Last updated
09/25/2019
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