Organization
NORTH GEORGIA AUTISM CENTER, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JESSICA LYNN PUGH M.S., BCBA (PRESIDENT)
(770) 844-8624
Entity
Organization
Contact information
Practice address
1575 DAHLONEGA HWY, CUMMING, GA 30040-4528
(770) 844-8624
(770) 844-8643
Mailing address
PO BOX 38, CUMMING, GA 30028-0038
(770) 844-8624
(770) 844-8643
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
APC001104
GA
103TM1800X
Intellectual & Developmental Disabilities Psychologist
Primary
—
—
111NR0400X
Rehabilitation Chiropractor
CHIR007818
GA
Other
Enumeration date
04/04/2007
Last updated
09/29/2008
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