Healthcare Provider Details

I. General information

NPI: 1275445850
Provider Name (Legal Business Name): JAYLA GRIER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/19/2026
Last Update Date: 09/19/2026
Certification Date: 09/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

303 PERIMETER CTR N
ATLANTA GA
30346-3402
US

IV. Provider business mailing address

PO BOX 574
WADLEY GA
30477-0574
US

V. Phone/Fax

Practice location:
  • Phone: 770-264-1920
  • Fax:
Mailing address:
  • Phone: 478-206-5117
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-23-312457
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: