Individual
GWENDOLYN ABE DE LEON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
205 ROADRUNNER BLVD, LA FAYETTE, GA 30728-2161
(706) 638-4664
Mailing address
7204 FAIRBANKS RD, HIXSON, TN 37343-2409
Taxonomy
Speciality
Code
Description
License number
State
163WR0400X
Rehabilitation Registered Nurse
Primary
615507
NY
Other
Enumeration date
05/13/2025
Last updated
05/13/2025
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