Individual
SHANIQUA BARRON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6110 BRODICK LN, LITHIA SPRINGS, GA 30122-6884
(678) 267-6139
Mailing address
6110 BRODICK LN, LITHIA SPRINGS, GA 30122-6884
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4552
N/A
—
Enumeration date
05/06/2019
Last updated
05/06/2019
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