| South Georgia Behavior Associates | |
|
113 Southside Dr Nashville GA 31639 | |
| (850) 345-8336 | |
| Not Available |
| Full Name | South Georgia Behavior Associates |
|---|---|
| Speciality | Behavior Analyst |
| Location | 113 Southside Dr, Nashville, Georgia |
| Authorized Official Name and Position | Summer Maria Mingo (CO-OWNER, BCBA,) |
| Authorized Official Contact | 8503458336 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| South Georgia Behavior Associates 113 Southside Dr Nashville GA 31639 Ph: (850) 345-8336 | South Georgia Behavior Associates 113 Southside Dr Nashville GA 31639 Ph: (850) 345-8336 |
| NPI Number | 1992308605 |
|---|---|
| Provider Enumeration Date | 11/17/2020 |
| Last Update Date | 11/17/2020 |
| Certification Date | 11/17/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992308605 | NPI | - | NPPES |
| 003204507A | Medicaid | GA | |
| 003277334A | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
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