Individual
TRACY ROLLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3485 N DESERT DR, SUITE 104, EAST POINT, GA 30344-5724
(404) 941-9350
(404) 941-9606
Mailing address
3485 N DESERT DR, SUITE 104, EAST POINT, GA 30344-5724
(404) 941-9350
(404) 941-9606
Taxonomy
Speciality
Code
Description
License number
State
251300000X
Local Education Agency (LEA)
Primary
—
—
252Y00000X
Early Intervention Provider Agency
—
—
Other
Enumeration date
11/06/2013
Last updated
11/06/2013
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