Individual
DIANA S PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
310 RESEARCH DR APT 1102, ATHENS, GA 30605-2737
(571) 707-1638
Mailing address
310 RESEARCH DR APT 1102, ATHENS, GA 30605-2737
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
12/08/2025
Last updated
12/08/2025
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