Individual
PRACHI PARAG DIVEKAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1664 MARKET PLACE BLVD, CUMMING, GA 30041-7927
(470) 253-4121
(470) 299-7571
Mailing address
300 INTERNATIONAL PKWY STE 200, LAKE MARY, FL 32746-5028
(866) 610-0580
(407) 588-6294
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-23-69637
GA
106S00000X
Behavior Technician
20-110801
OH
Other
Enumeration date
03/04/2020
Last updated
11/28/2023
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