Individual
CHARLENE RICHARDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2421 WEVOK WAY, GRAYSON, GA 30017-4340
(678) 438-5292
Mailing address
2421 WEVOK WAY, GRAYSON, GA 30017-4340
(678) 438-5292
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
06/06/2018
Last updated
06/06/2018
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