Individual
MICHELE LEA BAGBY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
175 GWINNETT DR, LAWRENCEVILLE, GA 30045-8444
(770) 785-5190
Mailing address
6203 NIXON CIR NE, COVINGTON, GA 30014-6315
(678) 342-0814
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
01/22/2007
Last updated
07/08/2007
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