Individual
ERICA LEEANN DENSMORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
997 LEVI H KENNEDY RD, REIDSVILLE, GA 30453-5436
(912) 222-1586
Mailing address
1772 MALLARD RD, ODUM, GA 31555-8401
(912) 222-1586
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-25-425465
GA
Other
Enumeration date
05/30/2025
Last updated
05/30/2025
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