Healthcare Provider Details

I. General information

NPI: 1932034121
Provider Name (Legal Business Name): RYAN DOBSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2026
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1670 RIVERWATCH CT NW
KENNESAW GA
30152-7433
US

IV. Provider business mailing address

1670 RIVERWATCH CT NW
KENNESAW GA
30152-7433
US

V. Phone/Fax

Practice location:
  • Phone: 336-575-8894
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberRBT-23-308595
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: