Individual
DONALD DERISSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RBT
Contact information
Practice address
6505 SHILOH RD STE 100, ALPHARETTA, GA 30005-1645
(678) 648-7644
Mailing address
6505 SHILOH RD STE 100, ALPHARETTA, GA 30005-1645
(678) 648-7644
(317) 520-8200
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-21-182945
GA
Other
Enumeration date
09/23/2021
Last updated
06/12/2024
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