Individual
MARINA WOMACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
540 W THOMAS ST STE C, MILLEDGEVILLE, GA 31061-2745
(716) 545-6922
Mailing address
604 PRINCETON DR, DALLAS, GA 30157-0850
(716) 545-6922
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-24-74400
GA
Other
Enumeration date
07/23/2024
Last updated
06/11/2025
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