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Individual

DEIRDRE CARTER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
382 RACETRACK RD, MCDONOUGH, GA 30252-1022
(678) 691-2206
Mailing address
382 RACETRACK RD, MCDONOUGH, GA 30252-1022
(678) 691-2206

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-20-140953
GA
106S00000X
Behavior Technician

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
RBT-20-140953
RBT
GA
Enumeration date
10/04/2019
Last updated
02/09/2021
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