Individual
ROUDELINE RAYMOND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
221 OLD NORTON RD, FAYETTEVILLE, GA 30215-4922
(678) 416-8682
Mailing address
221 OLD NORTON RD, FAYETTEVILLE, GA 30215-4922
(678) 416-8682
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Enumeration date
08/31/2019
Last updated
08/31/2019
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