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General NPI Number Information
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NPI Number | 1790600971
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Entity Type | Individual
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Provider Name | SERENITY REIGN HILL
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Gender |
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Dates
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Enumeration Date | 08/13/2026
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Last Update Date | 08/13/2026
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Provider Practice Location Address
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Address Line | 3131 LAWRENCEVILLE SUWANEE RD STE A3
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City | SUWANEE
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State | GA
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Zip | 30024-7488
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Country | US
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Telephone | 470-589-1878
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Fax |
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Provider Business Mailing Address
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Address Line | 980 WALTHER BLVD APT 2723
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City | LAWRENCEVILLE
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State | GA
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Zip | 30043-8437
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Country | US
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Telephone | 678-826-7993
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Fax |
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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 | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State | GA
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