Individual
HOPE SCREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RBT
Contact information
Practice address
1401 WILLIAMS ST APT B, VALDOSTA, GA 31602-3837
(229) 415-1221
Mailing address
1401 WILLIAMS ST APT B, VALDOSTA, GA 31602-3837
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-19-94841
GA
Other
Enumeration date
03/16/2023
Last updated
03/16/2023
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