Individual
ELIZABTH KATHERINE SEPULVEDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7491 MOSSDALE WAY, COLUMBUS, GA 31909-1787
(850) 266-4697
Mailing address
7491 MOSSDALE WAY, COLUMBUS, GA 31909-1787
(850) 266-4697
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-22-210301
GA
Other
Enumeration date
05/19/2022
Last updated
05/19/2022
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