Healthcare Provider Details

I. General information

NPI: 1922903038
Provider Name (Legal Business Name): JONATHAN ISAIAH DOSS RBT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/09/2026
Last Update Date: 10/09/2026
Certification Date: 10/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3993 LAWRENCEVILLE HWY NW STE 110
LILBURN GA
30047-2831
US

IV. Provider business mailing address

3620 ROSETREE CT
LILBURN GA
30047-7808
US

V. Phone/Fax

Practice location:
  • Phone: 140-440-7522
  • Fax:
Mailing address:
  • Phone: 470-599-7698
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: