Individual
JONTAE' SCOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1121 MICHAEL ST, LOCKPORT, IL 60441-3321
(855) 832-6727
(772) 675-9100
Mailing address
354 OLD WADLEY RD, MIDVILLE, GA 30441-4005
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
—
106S00000X
Behavior Technician
Primary
RBT-23-273892
GA
Other
Enumeration date
01/10/2024
Last updated
01/10/2024
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