Individual
DERECK KENDALL QUARLES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2401 BATTLECREEK VILLAGE DR, JONESBORO, GA 30236-8539
(404) 538-2390
Mailing address
2401 BATTLECREEK VILLAGE DR, JONESBORO, GA 30236-8539
(404) 538-2390
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-20-146994
GA
Other
Enumeration date
12/16/2020
Last updated
12/16/2020
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