Individual
MRS. CLARISSA BROOKINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RBT
Contact information
Practice address
112 JEFFERSON STREET, NEWNAN, GA 30263
(877) 288-4760
Mailing address
49 MATADOR WAY, NEWNAN, GA 30263-1195
(708) 642-1511
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-18-73649
GA
Other
Enumeration date
10/09/2019
Last updated
10/09/2019
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