Organization
EXCEPTIONALLY YOURS AUTISM AND EDUCATIONAL SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DEBORAH SILLSP PHD, LCSW (CEO)
(678) 849-0505
Entity
Organization
Contact information
Practice address
6754 GREY ROCK WAY, LITHONIA, GA 30058-3077
(678) 849-0505
Mailing address
PO BOX 784, LITHONIA, GA 30058-0784
(678) 849-0505
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
1041C0700X
Clinical Social Worker
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
102014
BEHAVIORAL HEALTH PROVIDER
GA
Enumeration date
08/19/2019
Last updated
08/19/2019
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