Sophia Holland

Individual provider Active NPI Behavior Technician · Forsyth, GA

NPI 1548091820 · NPPES record last updated Aug 9, 2024

Key facts

NPI
1548091820
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
Practice address
6908, 558 Ga-83
Forsyth, GA 31029
Phone
(478) 994-7066
NPI assigned
Aug 9, 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 GA Yes

Addresses

Primary practice location

6908, 558 Ga-83
Forsyth, GA 31029

Mailing address

530 Fawn Rd
Forsyth, GA 31029-3831
Phone (478) 957-3060

Other providers in Forsyth, GA

All providers in Forsyth, GA · Behavior Technician in Georgia

Sources for this page

Verify at the official NPI Registry.