Individual
MISS CHRISTELLE AWA BALEGAMIRE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5533 FOREST DR, LOGANVILLE, GA 30052-3471
(678) 887-8244
Mailing address
5533 FOREST DR, LOGANVILLE, GA 30052-3471
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
12/17/2018
Last updated
12/17/2018
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