Individual
DEVORAH LATICIA STORY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BA
Contact information
Practice address
131 MONTROSE WAY, LAGRANGE, GA 30240-7729
(404) 852-1772
Mailing address
131 MONTROSE WAY, LAGRANGE, GA 30240-7729
(404) 852-1772
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
GA
Other
Enumeration date
05/09/2018
Last updated
05/09/2018
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