Organization
SUNRISE BEHAVIORAL THERAPY LLC
Active
Other names
Sunrise Behavioral Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
SAMANTHA EMILIE MOELLER BCBA (BCBA/OWNER)
(209) 597-6489
Entity
Organization
Contact information
Practice address
20 HINSON ST STE 5, HAZLEHURST, GA 31539-6115
(209) 597-6489
Mailing address
20 HINSON ST STE 5, HAZLEHURST, GA 31539-6115
(209) 597-6489
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003271067C
—
GA
Enumeration date
09/24/2024
Last updated
10/07/2024
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