Individual
PRISCILLA TOLUWANIMI AJALA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
550 WRENHAVEN CT, LOGANVILLE, GA 30052-6232
(470) 699-6331
Mailing address
550 WRENHAVEN CT, LOGANVILLE, GA 30052-6232
(470) 699-6331
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
CN0030062299
GA
Other
Enumeration date
05/26/2023
Last updated
05/26/2023
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