Individual
VALARIE BELLAH FASUE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1783 HIGHWAY 42 N, MCDONOUGH, GA 30253-4725
(678) 759-0420
Mailing address
1783 HIGHWAY 42 N, MCDONOUGH, GA 30253-4725
(678) 759-0420
Taxonomy
Speciality
Code
Description
License number
State
171400000X
Health & Wellness Coach
—
—
174400000X
Specialist
—
GA
246RP1900X
Phlebotomy Technician
11D2292287
GA
246RP1900X
Phlebotomy Technician
Primary
—
—
Other
Enumeration date
05/10/2023
Last updated
08/09/2024
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