Individual
COURTNEY MUCKLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
296 MERCHANTS SQ, DALLAS, GA 30132-5029
(470) 391-2300
(470) 592-6581
Mailing address
300 INTERNATIONAL PKWY STE 200, LAKE MARY, FL 32746-5028
(407) 915-7729
(407) 588-6294
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-24-78062
GA
106E00000X
Assistant Behavior Analyst
0-23-14574
GA
106S00000X
Behavior Technician
RBT-19-97737
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103K0000X
—
GA
Enumeration date
06/22/2020
Last updated
12/17/2024
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