Most Relevant Information
Provider Data
| NPI Number: | 1003437005 |
| Provider Name: | PREMA PERVIN RBT |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: | 19-81172 |
Most Important Dates
| Enumeration Date: | 04/30/2020 |
| Last Updated: | 04/30/2020 |
Provider Practice Location
6505 SHILOH RD STE 100
ALPHARETTA
GA
300051645
Practice Location Phone/Fax
| Phone: | 6786487644 |
| Fax: |
Provider Mailing Location
6505 SHILOH RD STE 100
ALPHARETTA
GA
300051645
Provider Mailing Phone/Fax
| Phone: | 6786487644 |
| Fax: |