Individual
CRICKET CHEYENNE GULLICKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1371 BRIARVISTA WAY NE, ATLANTA, GA 30329
(920) 348-3688
Mailing address
1371 BRIARVISTA WAY NE, ATLANTA, GA 30329-3634
(920) 348-3688
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
07/12/2017
Last updated
07/21/2022
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