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Individual

IGNACIO RICARDO MENDOZA III

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
1751 DUNBARTON DR, LITHONIA, GA 30058-5507
(404) 583-6481
Mailing address
1751 DUNBARTON DR, LITHONIA, GA 30058-5507
(404) 583-6481

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary

Other

Enumeration date
12/11/2024
Last updated
12/11/2024
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