Individual
MISS JANELLE TRIVIA RICHARDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
680 THORNTON WAY, LITHIA SPRINGS, GA 30122-2600
(470) 734-8231
Mailing address
680 THORNTON WAY, LITHIA SPRINGS, GA 30122-2600
(470) 734-8231
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT23253882
GA
Other
Enumeration date
02/24/2023
Last updated
02/24/2023
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