Individual
MONICA TRIPP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
107 E BROAD ST, GREENSBORO, GA 30642-1337
(706) 453-9055
Mailing address
45 FAIRWOODS CT, COVINGTON, GA 30016-1141
(404) 387-7043
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
522414247
SOUL PROPRIETER
GA
Enumeration date
08/16/2016
Last updated
08/16/2016
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