Individual
EBONE TAMAR WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6537 BIMINI DR, FOREST PARK, GA 30297-3473
(678) 435-7187
Mailing address
6537 BIMINI DR, FOREST PARK, GA 30297-3473
(678) 435-7187
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
12/06/2024
Last updated
12/06/2024
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