Individual
DESTINEE ROSE INGRAO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3758 BUREL MILL DR, BUFORD, GA 30519-1975
(678) 200-4832
Mailing address
3758 BUREL MILL DR, BUFORD, GA 30519-1975
(678) 200-4832
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
03/16/2015
Last updated
03/16/2015
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