Individual
MIRANDA ELISE COLEGROVE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S.
Contact information
Practice address
3001 MERCER UNIVERSITY DR, ATLANTA, GA 30341-4115
(678) 547-6212
Mailing address
1468 BRIARWOOD RD NE UNIT 1402, BROOKHAVEN, GA 30319-5742
(979) 583-8896
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
11/28/2022
Last updated
11/28/2022
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