Nasra Mustaf Isaak

Individual provider Active NPI Behavior Technician · Clarkston, GA

NPI 1235836636 · NPPES record last updated Feb 15, 2023

Key facts

NPI
1235836636
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
Practice address
751 N Indian Creek Dr Apt 650
Clarkston, GA 30021-2339
Phone
(614) 218-4453
NPI assigned
Feb 15, 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

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X Yes

Addresses

Primary practice location

751 N Indian Creek Dr Apt 650
Clarkston, GA 30021-2339

Mailing address

751 N Indian Creek Dr Apt 650
Clarkston, GA 30021-2339
Phone (614) 218-4453

Other providers in Clarkston, GA

All providers in Clarkston, GA · Behavior Technician in Georgia

Sources for this page

Verify at the official NPI Registry.