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Individual

FERNANDO GORCA HANCOCK R DONALDSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
3981 ATLANTA HWY STE 6, LOGANVILLE, GA 30052-3759
(404) 781-9492
Mailing address
2979 WILSONE PL, SNELLVILLE, GA 30039-6150
(678) 986-0557

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
GA

Other

Enumeration date
08/04/2025
Last updated
08/04/2025
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