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General NPI Number Information
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NPI Number | 1659923951
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Entity Type | Individual
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Provider Name | GARLAND SUMMERS QASP
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Gender | Male
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Dates
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Enumeration Date | 07/16/2019
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Last Update Date | 07/16/2019
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Provider Practice Location Address
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Address Line | 10164 FORD AVE STE D
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City | RICHMOND HILL
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State | GA
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Zip | 31324-3948
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Country | US
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Telephone | 912-660-1100
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Fax | 912-445-0023
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Provider Business Mailing Address
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Address Line | 10164 FORD AVE STE D
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City | RICHMOND HILL
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State | GA
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Zip | 31324-3948
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Country | US
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Telephone | 912-660-1100
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Fax | 912-445-0023
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106E00000X
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Taxonomy Name | Assistant Behavior Analyst
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License Number |
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License Number State |
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