Individual
ELIZABETH MBOGOH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4843 GREEN FOREST CT NW, ACWORTH, GA 30102-3498
(404) 947-9690
Mailing address
4843 GREEN FOREST CT NW, ACWORTH, GA 30102-3498
(404) 947-9690
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
GA
Other
Enumeration date
03/19/2024
Last updated
03/19/2024
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