Individual
MATTAVIA SMALLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
209 7TH ST, AUGUSTA, GA 30901-1486
(706) 842-5330
(706) 842-5340
Mailing address
209 7TH ST FL 3, AUGUSTA, GA 30901-1486
(706) 842-5330
(706) 842-5340
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-21-51736
GA
106S00000X
Behavior Technician
RBT-17-34572
SC
Other
Enumeration date
07/05/2018
Last updated
07/30/2024
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