Individual
ALISHA MEWBORN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
168 N JOHNSTON ST STE 305, DALLAS, GA 30132-4741
(770) 558-7467
Mailing address
1365 VILLA RICA RD, POWDER SPRINGS, GA 30127-1105
(770) 558-7467
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
GA
Other
Enumeration date
07/15/2024
Last updated
07/15/2024
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