Individual
SHONTA MOTTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
10714 BUCKINGHAM CIR, HAMPTON, GA 30228-3253
(678) 962-3622
Mailing address
10714 BUCKINGHAM CIR, HAMPTON, GA 30228-3253
(678) 962-3622
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
46-4911287
GA
347C00000X
Private Vehicle
46-4911287
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
46-4911287
—
GA
Enumeration date
03/14/2015
Last updated
03/14/2015
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