Individual
MS. CHEYENNE RACHELLE MIX I
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1565 HIGHWAY 34 E, NEWNAN, GA 30265-2401
(877) 288-4760
Mailing address
152 GREENFIELD WAY, NEWNAN, GA 30263-7073
(678) 953-9888
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
08/25/2022
Last updated
08/25/2022
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