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Individual

MRS. NYMPHA J. MATHURIN MEADOWS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.ED, BCBA

Contact information

Practice address
11340 LAKEFIELD DR STE 200, JOHNS CREEK, GA 30097-2456
(800) 331-8604
(800) 331-8604
Mailing address
2100 RIVERSIDE PKWY, SUITE 128 - 144, LAWRENCEVILLE, GA 30043-5368
(800) 331-8604
(800) 331-8604

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
106S00000X
Behavior Technician
251S00000X
Community/Behavioral Health Agency

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1205138864
GA
05
1700300795
GA
Enumeration date
08/01/2017
Last updated
07/27/2022
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