Individual
IYANA KIMBROUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
611 OLD TANYARD RD, VILLA RICA, GA 30180-2408
(773) 636-6574
Mailing address
611 OLD TANYARD RD, VILLA RICA, GA 30180-2408
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
06/13/2024
Last updated
06/13/2024
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