Organization
CREEKSIDE AUTISM CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MYRLAINE DARIUS (ADMIN DIRECTOR)
(770) 888-5221
Entity
Organization
Contact information
Practice address
4035 JOHNS CREEK PKWY STE B, SUWANEE, GA 30024-1213
(770) 888-5221
(678) 680-5929
Mailing address
4055 JOHNS CREEK PKWY STE A, SUWANEE, GA 30024-1299
(770) 888-5221
(678) 680-5929
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
106E00000X
Assistant Behavior Analyst
—
—
106S00000X
Behavior Technician
—
—
Other
Enumeration date
10/06/2023
Last updated
10/06/2023
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