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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

LAQUASHIA SHAWNTELL WIDER, BT

Active

LAQUASHIA SHAWNTELL WIDER, BT is a Behavior Technician healthcare provider located in FAYETTEVILLE, Georgia. NPI 1992513105 is currently active in the NPPES registry. Verify at CMS.

Behavior Technician · FAYETTEVILLE, GA

Registration Details

NPI Number
1992513105
Provider Type
Individual
Gender
Female
NPI Issued
Dec 19, 2024 (1.6157218437054 yrs)
Last Updated
Dec 19, 2024

Practice Information

Address
120 BERKLEY PL
FAYETTEVILLE, GA, 302143720
Browse GA providers · Browse ZIP 30214
Phone
4046629116
Primary Specialty
Behavior Technician
106S00000X

Other Behavior Technician Providers in FAYETTEVILLE, GA

Name Credential NPI
BENJAMIN TYLER BULLARD 1538785977
JUSTICE MALEE PERRY BA 1013534403
KASHIA WATERTON RBT 1962012195
SHARON LEE JACKSON MS 1558973164
MARTHA LAUREN BLAIDES BSW 1508471400
MIEKA MATTIE KRISTIA GILLESPIE BS 1871108696
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.