Phantashia Shine

NPI #1780444570 in Lithonia, Georgia

Provider Information

NPI Number: 1780444570
Entity Type: Individual
Name: Phantashia Shine
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Behavior Technician
Enumeration Date: Mar 20, 2024
Last Updated: Mar 20, 2024

Practice Location

Address: 6647 CHIRCAHUA DR
City: Lithonia
State: Georgia
ZIP Code: 30038-3128
Phone: (770) 771-8741

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Technician	106S00000X	Primary

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