Kim Nicole Otelus

NPI #1306435763 in Lithonia, Georgia

Provider Information

NPI Number: 1306435763
Entity Type: Individual
Name: Kim Nicole Otelus
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Behavior Technician
Enumeration Date: Jan 11, 2021
Last Updated: Jan 11, 2021

Practice Location

Address: 3001 HERITAGE VILLA DR
City: Lithonia
State: Georgia
ZIP Code: 30038-2478
Phone: (678) 954-9649

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Technician	106S00000X	Primary

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