Individual
KENNETH BASKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4405 MALL BLVD, SUITE 200, UNION CITY, GA 30291-2044
(779) 969-4309
(770) 969-4170
Mailing address
4405 MALL BLVD, SUITE 200, UNION CITY, GA 30291-2044
(779) 969-4309
(770) 969-4170
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
03/18/2014
Last updated
03/18/2014
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