Julietta Avila Gamboa

NPI #1104639715 in Tyrone, Georgia

Provider Information

NPI Number: 1104639715
Entity Type: Individual
Name: Julietta Avila Gamboa
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Behavior Technician
Enumeration Date: Jan 28, 2025
Last Updated: Jan 28, 2025

Practice Location

Address: 120 HANDLEY RD STE 410
City: Tyrone
State: Georgia
ZIP Code: 30290-2174
Phone: (770) 629-4660

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Technician	106S00000X	Primary

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