Individual
JAQUANDRALYN ANTREL'LE DUMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RBT
Contact information
Practice address
115 CHAPMAN RIDGE RD, MACON, GA 31211-7270
(478) 796-4408
Mailing address
115 CHAPMAN RIDGE RD, MACON, GA 31211-7270
(478) 796-4408
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-25-404544
GA
Other
Enumeration date
01/14/2025
Last updated
01/14/2025
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