Individual
GWEN DELL ROBINSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
319 ELM DR, VILLA RICA, GA 30180-1913
(770) 309-9333
Mailing address
319 ELM DR, VILLA RICA, GA 30180-1913
(770) 309-9333
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
03/03/2016
Last updated
03/03/2016
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