Individual
JACLYN YIN
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
158 CROWN WALK, MCDONOUGH, GA 30253-4648
(770) 605-7051
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-19-101739
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RBT-19-101739
RBT
GA
Enumeration date
03/09/2020
Last updated
03/09/2020
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