Individual
MS. DYNASTY GAMMAGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8900 CARROLL MANOR DR, ATLANTA, GA 30350-2087
(562) 291-9002
Mailing address
8900 CARROLL MANOR DR, ATLANTA, GA 30350-2087
(562) 291-9002
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
1198878
GA
Other
Enumeration date
08/13/2025
Last updated
08/13/2025
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