Individual
TRACIE R VALERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CEO
Contact information
Practice address
2979 SAVANNAH WALK LN, SUWANEE, GA 30024-3658
(678) 662-5464
Mailing address
2090 LAWRENCEVILLE SUWANNEE RD A, #202, SUWANEE, GA 30024
(678) 662-5464
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
08/20/2020
Last updated
08/20/2020
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