Individual
AMYRATH-LAYE A SOURADJOU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
108 LUCAS LN, VOORHEES, NJ 08043-2549
(856) 772-0060
Mailing address
770 WOODLANE RD, WESTAMPTON, NJ 08060-3804
(609) 267-5928
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
02/16/2015
Last updated
02/16/2015
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