Individual
AIYANA AUSTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
508 N MAIN ST STE D, HINESVILLE, GA 31313-2570
(912) 756-0656
(904) 538-0714
Mailing address
10175 FORTUNE PKWY UNIT 903, JACKSONVILLE, FL 32256-6755
(904) 538-0713
(904) 538-0714
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-19-106900
GA
Other
Enumeration date
11/22/2019
Last updated
11/22/2019
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