Christy Phan
Behavior Technician in Marietta, GA. Individual provider (NPI-1).
NPI number1194469049
StatusActive
Last updated in NPPESApr 26, 2022
Details
- NPI
- 1194469049
- Entity type
- Individual (NPI-1)
- Name
- Christy Phan
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Apr 26, 2022
- Certification date
- Apr 25, 2022
- Last updated
- Apr 26, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 106S00000X | Behavior Technician | – | – | Yes |
Practice location
1519 Johnson Ferry Rd Bldg 10Marietta, GA 30062-6409
Phone 866-523-4268
Mailing address
Dept La 22763Pasadena, CA 91185-2763
Phone 866-523-4268
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