Individual
SONYA COUTEE WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
WHNP-BC
Contact information
Practice address
3200 HIGHLANDS PKWY SE STE 420, SMYRNA, GA 30082-5192
(678) 424-1123
Mailing address
3239 BOROGROVE WAY, DECATUR, GA 30032-5980
(404) 218-5475
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
RN163190
GA
Other
Enumeration date
07/06/2019
Last updated
07/06/2019
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