Organization
KICKLIGHTER RESOURCE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STACEY DAVIS (CEO/EXECUTIVE DIRECTOR)
(912) 355-7633
Entity
Organization
Contact information
Practice address
7219 SEAWRIGHT DR, SAVANNAH, GA 31406-2703
(912) 355-7633
(912) 355-4206
Mailing address
PO BOX 13625, SAVANNAH, GA 31416-0625
(912) 355-7633
(912) 355-4206
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
261Q00000X
Clinic/Center
—
—
Other
Enumeration date
06/26/2009
Last updated
05/25/2023
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