Individual
WANDA CHAMPION
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1231 JOSEPH E BOONE BLVD NW, ATLANTA, GA 30314-2395
(404) 817-9994
(404) 817-9994
Mailing address
2815 SHELLEY LN, ELLENWOOD, GA 30294-4036
(404) 291-4844
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
02/11/2025
Last updated
02/11/2025
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