| Sunrise Behavioral Therapy | |
|
20 Hinson St Ste 5 Hazlehurst GA 31539-6115 | |
| (209) 597-6489 | |
| Not Available |
| Full Name | Sunrise Behavioral Therapy |
|---|---|
| Speciality | Behavior Analyst |
| Location | 20 Hinson St Ste 5, Hazlehurst, Georgia |
| Authorized Official Name and Position | Samantha Emilie Moeller (BCBA/OWNER) |
| Authorized Official Contact | 2095976489 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sunrise Behavioral Therapy 20 Hinson St Ste 5 Hazlehurst GA 31539-6115 Ph: (209) 597-6489 | Sunrise Behavioral Therapy 20 Hinson St Ste 5 Hazlehurst GA 31539-6115 Ph: (209) 597-6489 |
| NPI Number | 1770300477 |
|---|---|
| Provider Enumeration Date | 09/24/2024 |
| Last Update Date | 10/07/2024 |
| Certification Date | 10/07/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770300477 | NPI | - | NPPES |
| 003271067C | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
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