Individual
EBONIE BROWN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4434 COLUMBIA RD STE 105, MARTINEZ, GA 30907-4563
(706) 955-7687
(706) 535-3596
Mailing address
4434 COLUMBIA RD STE 105, MARTINEZ, GA 30907-4563
(803) 624-3885
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-23-291780
—
Other
Enumeration date
09/12/2024
Last updated
09/12/2024
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