Individual
MISS DARYL-LESHA KOREA ALSTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RBT
Contact information
Practice address
408 BEDELL AVE, WOODBINE, GA 31569-3585
(912) 409-7889
(404) 953-7889
Mailing address
3875 DARIEN HWY APT 9C, BRUNSWICK, GA 31525-2495
(912) 297-7165
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-22-238301
GA
Other
Enumeration date
10/11/2022
Last updated
10/11/2022
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