Ruby Alsobrook

Individual provider Active NPI Behavior Technician · La Fayette, GA

NPI 1215722004 · NPPES record last updated Apr 11, 2025

Key facts

NPI
1215722004
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
Practice address
229 Langley Dr
La Fayette, GA 30728-7413
Phone
(423) 260-6103
NPI assigned
Apr 11, 2025
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

229 Langley Dr
La Fayette, GA 30728-7413

Mailing address

229 Langley Dr
La Fayette, GA 30728-7413

Other providers in La Fayette, GA

All providers in La Fayette, GA · Behavior Technician in Georgia

Sources for this page

Verify at the official NPI Registry.