Jana Gills

Individual provider Active NPI Behavior Technician · Tyrone, GA

NPI 1295516045 · NPPES record last updated Oct 9, 2023

Key facts

NPI
1295516045
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
License
RBT-23-302522 (GA)
Practice address
1135 Senoia Rd
Tyrone, GA 30290-1625
Phone
(770) 626-3044
NPI assigned
Oct 9, 2023
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

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-23-302522GAMDBehavior Technician

Practice roles

OrganizationSpecialtyStatusNew patients
Southside ABA LLC Current
since Oct 15, 2023
Accepting new patients

Locations

1135 Senoia Rd
Tyrone, GA 30290
Phone (770) 626-3044

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X RBT-23-302522 GA Yes

Addresses

Primary practice location

1135 Senoia Rd
Tyrone, GA 30290-1625

Mailing address

1135 Senoia Rd
Tyrone, GA 30290-1625
Phone (770) 626-3044

Other providers in Tyrone, GA

All providers in Tyrone, GA · Behavior Technician in Georgia

Sources for this page

Verify at the official NPI Registry.