Individual
LAKETA ROBERTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3307 WHITE CASTLE DR, DECATUR, GA 30034-5444
(678) 707-1426
Mailing address
3307 WHITE CASTLE DR, DECATUR, GA 30034-5444
(678) 707-1426
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
044-R-0841
GA
Other
Enumeration date
12/12/2013
Last updated
12/12/2013
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