Individual
DONNA JOACHIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS SPED ED
Contact information
Practice address
4061 SUZANNE DR STE CANDD, DIBERVILLE, MS 39540-3735
(228) 396-4434
(228) 396-4438
Mailing address
4061 SUZANNE DR STE CANDD, DIBERVILLE, MS 39540-3735
(228) 396-4434
(228) 396-4438
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
RBT# 16-12450
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1891084414
MS CENTERS FOR AUTISM AND OTHER RELATED DEVELOPMENTAL DISABILITIES
MS
Enumeration date
04/26/2016
Last updated
04/26/2016
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