Individual
MRS. TIFFANY HOWARD BALKCOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
261 DOVE PL, SOCIAL CIRCLE, GA 30025-3068
(140) 499-4847
Mailing address
261 DOVE PL, SOCIAL CIRCLE, GA 30025-3068
(404) 944-8472
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-2368049
GA
Other
Enumeration date
03/07/2023
Last updated
09/11/2023
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