Individual
QUANIQUA CARLIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COO
Contact information
Practice address
2610 MILLEDGEVILLE RD, AUGUSTA, GA 30904-5110
(804) 300-6723
Mailing address
750 FORDHAM RD, GROVETOWN, GA 30813-0400
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
01/16/2023
Last updated
11/20/2023
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