Victoria White
Individual provider Active NPI Behavior Technician · Lula, GA
NPI 1043058688 · NPPES record last updated Jul 17, 2024
Key facts
- NPI
- 1043058688
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Technician 106S00000X
- Practice address
- 7812 Persimmon Tree Rd
Lula, GA 30554-2401 - Phone
- (770) 539-2616
- NPI assigned
- Jul 17, 2024
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | Yes |
Addresses
Primary practice location
7812 Persimmon Tree Rd
Lula, GA 30554-2401
Mailing address
7812 Persimmon Tree Rd
Lula, GA 30554-2401
Phone (770) 539-2616
Other providers in Lula, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 17, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.