Individual
CHANNELLE ANANDA JACQUES-LOUIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4900 IVEY RD SUITE 1626, ACWORTH, GA 30101
(470) 531-0510
Mailing address
4900 IVEY RD SUITE 1626, ACWORTH, GA 30101
(470) 531-0510
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
06/17/2025
Last updated
06/17/2025
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