Healthcare Provider Details

I. General information

NPI: 1225964539
Provider Name (Legal Business Name): NEVA N COULTER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/23/2026
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3926 US HIGHWAY 17
RICHMOND HILL GA
31324-3360
US

IV. Provider business mailing address

3926 US HIGHWAY 17
RICHMOND HILL GA
31324-3360
US

V. Phone/Fax

Practice location:
  • Phone: 573-712-8559
  • Fax:
Mailing address:
  • Phone: 573-712-8559
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: