Most Relevant Information
Provider Data
| NPI Number: | 1003400748 |
| Provider Name: | TAJA BROTHERS RBT |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 02/23/2021 |
| Last Updated: | 02/23/2021 |
Provider Practice Location
382 RACETRACK RD
MCDONOUGH
GA
302521022
Practice Location Phone/Fax
| Phone: | 6786912206 |
| Fax: |
Provider Mailing Location
416 CAMELLA CIR
MCDONOUGH
GA
302528918
Provider Mailing Phone/Fax
| Phone: | 6789722476 |
| Fax: |