Individual
AMANDA NICOLE GATES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BA
Contact information
Practice address
2909 CAMPBELLTON RD SW APT 19G, ATLANTA, GA 30311-4509
(404) 740-0562
Mailing address
2909 CAMPBELLTON RD SW APT 19G, ATLANTA, GA 30311-4509
(404) 740-0562
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
GA
Other
Enumeration date
04/09/2019
Last updated
04/09/2019
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