Pearl Afetornu, RBT

Individual provider Active NPI Behavior Technician · Brookhaven, GA

NPI 1104501311 · NPPES record last updated Jun 16, 2023

Key facts

NPI
1104501311
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
License
RBT-23-263799 (GA)
Practice address
3105 Clairmont Rd NE
Brookhaven, GA 30329-1015
Phone
(470) 241-1353
Fax
(317) 520-8200
NPI assigned
Jun 16, 2023
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

State licenses

LicenseStateTypeSpecialty
RBT-23-263799GAMDBehavior Technician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X RBT-23-263799 GA Yes

Addresses

Primary practice location

3105 Clairmont Rd NE
Brookhaven, GA 30329-1015

Mailing address

3500 Depauw Blvd Ste 3070
Indianapolis, IN 46268-6135
Phone (855) 324-0885

Other providers in Brookhaven, GA

All providers in Brookhaven, GA · Behavior Technician in Georgia

Sources for this page

Verify at the official NPI Registry.