Individual
ALLISON ROQUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1224 HAMMOND DR NE STE 1500, ATLANTA, GA 30346-1537
(855) 485-8732
Mailing address
212 MIRALUNA DR, SAN BRUNO, CA 94066-1765
(916) 749-5031
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
—
164X00000X
Licensed Vocational Nurse
Primary
728611
CA
Other
Enumeration date
09/17/2018
Last updated
09/27/2023
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