Tiesha Houston

Individual provider Active NPI Behavior Technician · Bowdon, GA

NPI 1720829930 · NPPES record last updated Jun 3, 2024

Key facts

NPI
1720829930
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
Practice address
191 Harvell Dr Apt J2
Bowdon, GA 30108-1361
Phone
(470) 990-3185
NPI assigned
Jun 3, 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 Yes

Addresses

Primary practice location

191 Harvell Dr Apt J2
Bowdon, GA 30108-1361

Mailing address

191 Harvell Dr Apt J2
Bowdon, GA 30108-1361
Phone (470) 990-3185

Other providers in Bowdon, GA

All providers in Bowdon, GA · Behavior Technician in Georgia

Sources for this page

Verify at the official NPI Registry.