Organization
SOUTH GEORGIA BEHAVIOR ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUMMER MARIA MINGO BCBA (CO-OWNER, BCBA,)
(850) 345-8336
Entity
Organization
Contact information
Practice address
113 SOUTHSIDE DR, NASHVILLE, GA 31639
(850) 345-8336
Mailing address
113 SOUTHSIDE DR, NASHVILLE, GA 31639
(850) 345-8336
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003204507A
—
GA
05
—
003277334A
—
GA
Enumeration date
11/17/2020
Last updated
11/17/2020
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