Organization
SALLY M WAY TULLY
Active
Other names
ABA Therapy Center
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SALLY M WAY TULLY BCBA (EXECUTIVE DIRECTOR)
(912) 660-1100
Entity
Organization
Contact information
Practice address
10164 FORD AVE STE D, RICHMOND HILL, GA 31324-3948
(912) 660-1100
Mailing address
PO BOX 1822, RICHMOND HILL, GA 31324-1822
(912) 660-1100
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-13-12747
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1-13-12747
BEHAVIOR ANALYST CERTIFICATION BOARD
—
Enumeration date
03/07/2013
Last updated
03/07/2013
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