Individual
MISS EMILY BROOKE RICHARDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6011 WATSON BLVD STE AND340, BYRON, GA 31008-6646
(478) 225-3880
Mailing address
181 W PROFESSIONAL PARK CT STE 1, BOWLING GREEN, KY 42104-3250
(270) 777-9283
(270) 777-9283
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
16-23271
GA
Other
Enumeration date
07/23/2013
Last updated
02/26/2018
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