# MTRAC HEALTHCARE

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1467106153
- **Authorized official:** FATIMAT AGBOJEYIN (OWNER)
- **Authorized official phone:** (404) 513-2868

## Contact information

- **Practice address:** 105 EMERALD LAKE CT, FAYETTEVILLE, GA 30215-7748
- **Practice address phone:** (404) 513-2868
- **Mailing address:** 105 EMERALD LAKE CT, FAYETTEVILLE, GA 30215-7748
- **Mailing address phone:** (404) 513-2868

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 02/10/2022
- **Last updated:** 02/10/2022