Individual
MIMA FONDONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
720 WESTVIEW DR SW, ATLANTA, GA 30310-1458
(832) 808-3664
Mailing address
1311 MCMURTRY RIDGE DR, KATY, TX 77494-4080
(832) 808-3664
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
GA
Other
Enumeration date
04/20/2023
Last updated
04/20/2023
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