Individual
FATOUMATA WAZIRI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
591 PADEN MILL TRL, LAWRENCEVILLE, GA 30044-6367
(240) 501-9474
Mailing address
591 PADEN MILL TRL, LAWRENCEVILLE, GA 30044-6367
(240) 501-9474
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
—
—
376J00000X
Homemaker
—
—
Other
Enumeration date
08/07/2018
Last updated
08/07/2018
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