Individual
IRMA REA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
130 FOE CREEK CT, ROSWELL, GA 30076-4645
(678) 524-6007
Mailing address
130 FOE CREEK CT, ROSWELL, GA 30076-4645
(678) 524-6007
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
08/06/2024
Last updated
08/06/2024
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