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Individual

JADE S. PRIMUS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1664 MARKET PLACE BLVD, CUMMING, GA 30041-7927
(470) 299-7571
Mailing address
175 MIDDLE ST UNIT 1201, LAKE MARY, FL 32746-3625
(810) 610-0580

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary

Other

Enumeration date
02/10/2019
Last updated
02/10/2019
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