Provider Demographics
NPI:1346826476
Name:FREMPONG, FIDELIA CHOOSE (RBT)
Entity Type:Individual
Prefix:MS
First Name:FIDELIA
Middle Name:CHOOSE
Last Name:FREMPONG
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4060 HERSCHEL RD APT H7
Mailing Address - Street 2:
Mailing Address - City:COLLEGE PARK
Mailing Address - State:GA
Mailing Address - Zip Code:30337-4539
Mailing Address - Country:US
Mailing Address - Phone:404-838-1238
Mailing Address - Fax:
Practice Address - Street 1:4060 HERSCHEL RD APT H7
Practice Address - Street 2:
Practice Address - City:COLLEGE PARK
Practice Address - State:GA
Practice Address - Zip Code:30337-4539
Practice Address - Country:US
Practice Address - Phone:404-838-1238
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-19
Last Update Date:2021-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician