Individual
DAIJAHNAE ALEXIA EVANS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N/A
Contact information
Practice address
2810 PREMIERE PKWY, DULUTH, GA 30097-5014
(866) 523-4268
Mailing address
858 DESHON CREEK DR, LITHONIA, GA 30058-2936
(678) 315-4136
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
06/03/2021
Last updated
06/03/2021
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