NPI age
7 years
Enumerated 2019-03-20
Across 2449 active community/behavioral health providers in Georgia.
| Type | Value | Notes |
|---|---|---|
| 01 (GA) | 071719050 | DRIVERS LICENSE |
| 01 (GA) | RBT-19-74736 | RBT REGISTRATION NUMBER |
Solo or small practice. No other active providers share this practice address in NPPES. This provider is listed as a sole proprietor.
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