| Success on the Spectrum | |
|
107 Upper Riverdale Rd Sw Riverdale GA 30274-2504 | |
| (770) 450-5467 | |
| Not Available |
| Full Name | Success on the Spectrum |
|---|---|
| Speciality | Behavior Analyst |
| Location | 107 Upper Riverdale Rd Sw, Riverdale, Georgia |
| Authorized Official Name and Position | Cayla Clark (OWNER) |
| Authorized Official Contact | 6784812390 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Success on the Spectrum 6317 Redan Sq Lithonia GA 30058-7105 | Success on the Spectrum 107 Upper Riverdale Rd Sw Riverdale GA 30274-2504 Ph: (770) 450-5467 |
| NPI Number | 1053032268 |
|---|---|
| Provider Enumeration Date | 09/06/2022 |
| Last Update Date | 02/22/2023 |
| Certification Date | 02/22/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053032268 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | () | Primary |
| 261QH0700X | Clinic/center - Hearing And Speech | () | Secondary |
| 261QX0100X | Clinic/center - Occupational Medicine | () | Secondary |
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