Individual
MAITRAM THI PHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BS.
Contact information
Practice address
4405 INTERNATIONAL BLVD STE C107, NORCROSS, GA 30093-3019
(470) 448-4714
(678) 840-3574
Mailing address
1375 STONEGATE LN SE, SMYRNA, GA 30080-4421
(770) 680-9967
(678) 840-3574
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
PHCP011130
GA
Other
Enumeration date
09/18/2025
Last updated
09/18/2025
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