Individual
OLIVIA ROSE THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
50 PLAZA WAY NW STE A, MARIETTA, GA 30060-1141
(678) 691-2206
Mailing address
50 PLAZA WAY NW STE A, MARIETTA, GA 30060-1141
(678) 691-2206
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-21-47538
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1-21-47538
BCBA
GA
Enumeration date
05/26/2021
Last updated
06/23/2021
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