Healthcare Provider Details

I. General information

NPI: 1104720226
Provider Name (Legal Business Name): AMARI SARIYAH PHILLIPS RBT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/03/2026
Last Update Date: 10/03/2026
Certification Date: 10/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2519 TREE TERRACE PKWY
AUSTELL GA
30168-5584
US

IV. Provider business mailing address

2519 TREE TERRACE PKWY
AUSTELL GA
30168-5584
US

V. Phone/Fax

Practice location:
  • Phone: 404-932-2723
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-24-340591
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: