Individual
KHADIJAH ADAMA TARAWALLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2151 PEACHFORD RD, ATLANTA, GA 30338-6599
(770) 455-3200
Mailing address
1186 MASTERS LN, SNELLVILLE, GA 30078-3583
(140) 437-5915
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
RN262730
GA
Other
Enumeration date
08/17/2023
Last updated
08/17/2023
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