Deshun Grove

Individual provider Active NPI Behavior Technician · Hoschton, GA

NPI 1922830306 · NPPES record last updated Aug 15, 2024

Key facts

NPI
1922830306
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
Practice address
902 Michigan Cir
Hoschton, GA 30548-5559
Phone
(770) 337-1645
NPI assigned
Aug 15, 2024
Sex
Female
Sole proprietor
Yes

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

902 Michigan Cir
Hoschton, GA 30548-5559

Mailing address

902 Michigan Cir
Hoschton, GA 30548-5559
Phone (770) 337-1645

Other providers in Hoschton, GA

All providers in Hoschton, GA · Behavior Technician in Georgia

Sources for this page

Verify at the official NPI Registry.