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3319 Sugarloaf Pkwy Lawrenceville GA 30044-5483 | |
| (866) 610-0580 | |
| (407) 588-6294 |
| Full Name | |
|---|---|
| Speciality | Behavior Analyst |
| Location | 3319 Sugarloaf Pkwy, Lawrenceville, Georgia |
| Authorized Official Name and Position | Jason Owen (CEO) |
| Authorized Official Contact | 4708166449 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
300 International Pkwy Ste 200 Lake Mary FL 32746-5028 Ph: (470) 816-6449 | 3319 Sugarloaf Pkwy Lawrenceville GA 30044-5483 Ph: (866) 610-0580 |
| NPI Number | 1881253110 |
|---|---|
| Provider Enumeration Date | 06/11/2019 |
| Last Update Date | 11/10/2022 |
| Certification Date | 11/10/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881253110 | NPI | - | NPPES |
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