Individual
LEIGH VANDERELS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
885 WOODSTOCK RD, SUITE 430-226, ROSWELL, GA 30075-2277
(850) 830-3419
Mailing address
PO BOX 170211, ATLANTA, GA 30317-0211
(850) 830-3419
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-03-1452
GA
Other
Enumeration date
06/22/2015
Last updated
06/22/2015
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