Individual
RAJEIVE ANTWAN MANRADGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LAPC, NCC
Contact information
Practice address
109 WHITE ROSE CT, LOGANVILLE, GA 30052-8644
(678) 697-4153
Mailing address
109 WHITE ROSE CT, LOGANVILLE, GA 30052-8644
(678) 697-4153
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
APC005768
GA
Other
Enumeration date
01/05/2017
Last updated
01/05/2017
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