Gradea Harris
Behavior Technician in Conyers, GA. Individual provider (NPI-1).
NPI number1124884150
StatusActive
Last updated in NPPESFeb 27, 2024
Details
- NPI
- 1124884150
- Entity type
- Individual (NPI-1)
- Name
- Gradea Harris
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Feb 27, 2024
- Certification date
- Feb 27, 2024
- Last updated
- Feb 27, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 106S00000X | Behavior Technician | – | – | Yes |
Practice location
1823 Millstone MnrConyers, GA 30013-1355
Phone 404-988-2450
Mailing address
1823 Millstone MnrConyers, GA 30013-1355
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