Individual
HEAVEN ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1777 WASHINGTON RD, EAST POINT, GA 30344-4159
(877) 288-4760
Mailing address
2308 TOLLIVER PL, ELLENWOOD, GA 30294-6289
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
11/08/2022
Last updated
11/08/2022
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