Gateway Medspa LLC DBA Dana

NPI #1609492693 in Leesburg, Georgia

Provider Information

NPI Number: 1609492693
Entity Type: Organization
Organization Name: Gateway Medspa LLC DBA Dana
Primary Specialty: Behavior Analyst
Enumeration Date: Jun 25, 2020
Last Updated: Dec 14, 2022

Practice Location

Address: 165 CEDRIC ST
City: Leesburg
State: Georgia
ZIP Code: 31763-5027
Phone: (229) 405-1900

Authorized Official

Name: MRS. TOKELA S HUSTON
Title: OWNER
Phone: (229) 854-0146

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Home Health	251E00000X
Public Health or Welfare	251K00000X
In Home Supportive Care	253Z00000X
Clinic/Center	261Q00000X
Clinic/Center - Health Service — Health Service	261QH0100X
Behavior Analyst	103K00000X	Primary

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