Healthcare Provider Details

I. General information

NPI: 1952229718
Provider Name (Legal Business Name): JON TOUDT RBT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/08/2026
Last Update Date: 07/08/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 HANDLEY RD STE 410
TYRONE GA
30290-2174
US

IV. Provider business mailing address

140 N DAVIS RD APT 310
LAGRANGE GA
30241-1599
US

V. Phone/Fax

Practice location:
  • Phone: 404-839-7934
  • Fax:
Mailing address:
  • Phone: 850-221-8432
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: