Provider Demographics
NPI:1598319857
Name:RICHARD, QUNISHA T (RBT)
Entity Type:Individual
Prefix:
First Name:QUNISHA
Middle Name:T
Last Name:RICHARD
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 1:3386 MOUNT ZION RD APT 418
Mailing Address - Street 2:
Mailing Address - City:STOCKBRIDGE
Mailing Address - State:GA
Mailing Address - Zip Code:30281-6882
Mailing Address - Country:US
Mailing Address - Phone:504-493-9702
Mailing Address - Fax:
Practice Address - Street 1:3386 MOUNT ZION RD APT 418
Practice Address - Street 2:
Practice Address - City:STOCKBRIDGE
Practice Address - State:GA
Practice Address - Zip Code:30281-6882
Practice Address - Country:US
Practice Address - Phone:504-493-9702
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-25
Last Update Date:2019-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician