Individual
GONTSE THEODELTIA UGBABE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
330 FOREST PL, LAWRENCEVILLE, GA 30046-8815
(470) 519-7448
Mailing address
330 FOREST PL, LAWRENCEVILLE, GA 30046-8815
(470) 519-7448
Taxonomy
Speciality
Code
Description
License number
State
163WC0400X
Case Management Registered Nurse
Primary
RN710143
GA
Other
Enumeration date
04/21/2026
Last updated
04/21/2026
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