Individual
MARIE ANN CHURCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
579 POTOMAC DR, TIGER, GA 30576-2731
(678) 986-0817
Mailing address
579 POTOMAC DR, TIGER, GA 30576-2731
(678) 986-0817
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
RBT-24-356254
GA
Other
Enumeration date
07/09/2024
Last updated
07/09/2024
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