Derrica Shavonta Anderson

NPI #1124700976 in Midland, Georgia

Provider Information

NPI Number: 1124700976
Entity Type: Individual
Name: Derrica Shavonta Anderson
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Behavior Technician
Enumeration Date: Aug 2, 2023
Last Updated: Aug 9, 2023

Practice Location

Address: 7730 LYNCH RD
City: Midland
State: Georgia
ZIP Code: 31820
Phone: (912) 385-4648

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Technician	106S00000X	Primary

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