Tanetra Denaye Bowens

Individual provider Active NPI Behavior Technician · Richmond Hill, GA

NPI 1043081698 · NPPES record last updated Jan 12, 2024

Key facts

NPI
1043081698
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
Practice address
2451B US Highway 17
Richmond Hill, GA 31324-3397
Phone
(515) 560-6622
NPI assigned
Jan 12, 2024
Sex
Female
Sole proprietor
No

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)CodeLicenseStatePrimary
Behavior Technician 106S00000X Yes

Addresses

Primary practice location

2451B US Highway 17
Richmond Hill, GA 31324-3397

Mailing address

6140 Jones Rd NW
Riceboro, GA 31323-1514
Phone (912) 230-1720

Other providers in Richmond Hill, GA

All providers in Richmond Hill, GA · Behavior Technician in Georgia

Sources for this page

Verify at the official NPI Registry.