Individual
HEIDI MIDDENDORF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RBT
Contact information
Practice address
112 JEFFERSON ST, NEWNAN, GA 30263-1421
(877) 288-4760
Mailing address
11 HEERY RD, NEWNAN, GA 30263-1319
(678) 523-7940
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
03/28/2022
Last updated
03/28/2022
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