Organization
NORTH GEORGIA AUTISM CENTER LLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BETHANY DANIELLE OLIVER CRAIG M.ED., BCBA (OWNER/DIRECTOR)
(765) 414-6227
Entity
Organization
Contact information
Practice address
9940 HIGHWAY 92, WOODSTOCK, GA 30188-6417
(765) 414-6227
Mailing address
9940 HIGHWAY 92, WOODSTOCK, GA 30188-6417
(765) 414-6227
(888) 979-8504
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003216615A
—
GA
Enumeration date
09/27/2018
Last updated
08/11/2022
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