Individual
MRS. SALLY M WAY-TULLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, BCBA
Contact information
Practice address
10164 FORD AVE, SUITE D, RICHMOND HILL, GA 31324-3949
(912) 660-1100
Mailing address
10164 FORD AVE, SUITE D, RICHMOND HILL, GA 31324-3949
(912) 660-1100
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-13-12747
GA
Other
Enumeration date
06/22/2011
Last updated
03/07/2013
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