Individual
DAWANTE THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
32 SHEFFIELD PL, CARTERSVILLE, GA 30121-8426
(678) 249-5622
Mailing address
32 SHEFFIELD PL, CARTERSVILLE, GA 30121-8426
(678) 249-5622
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-22-224982
GA
Other
Enumeration date
03/27/2023
Last updated
03/27/2023
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