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General NPI Number Information
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NPI Number | 1871481945
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Entity Type | Organization
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Legal Business Name | SONNY GROVE CONSULTING LLC
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Dates
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Enumeration Date | 06/26/2025
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Last Update Date | 12/29/2025
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Provider Practice Location Address
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Address Line | 386 GLYNN ST N
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City | FAYETTEVILLE
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State | GA
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Zip | 30214-1191
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Country | US
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Telephone | 404-400-5006
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Fax |
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Provider Business Mailing Address
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Address Line | 386 GLYNN ST N
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City | FAYETTEVILLE
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State | GA
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Zip | 30214-1191
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Country | US
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Telephone | 404-400-5006
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. CHARLOTTE KELLY
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Credential | MBA, ED.D.
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Telephone | 404-400-5006
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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