Healthcare Provider Details

I. General information

NPI: 1760392013
Provider Name (Legal Business Name): PRESLEY BRYAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: PRESLEY NATION

II. Dates (important events)

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

III. Provider practice location address

1401 GEORGIAN PARK STE 220
PEACHTREE CITY GA
30269-6974
US

IV. Provider business mailing address

5881 REINHARDT COLLEGE PKWY
WALESKA GA
30183-3613
US

V. Phone/Fax

Practice location:
  • Phone: 877-438-1265
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License NumberLABA000062
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: