Sanquell-La'shae Ivory

NPI #1700767001 in Midway, Georgia

Provider Information

NPI Number: 1700767001
Entity Type: Individual
Name: Sanquell-La'shae Ivory
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Behavior Technician
Enumeration Date: Sep 11, 2025
Last Updated: Sep 11, 2025

Practice Location

Address: 998 BACONTOWN RD
City: Midway
State: Georgia
ZIP Code: 31320
Phone: (912) 532-2635

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Technician	106S00000X	Primary

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