Individual
MARIE ALICE CEDOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1948 KELVIN DR, LAWRENCEVILLE, GA 30043-3154
(770) 237-2865
Mailing address
1948 KELVIN DR, LAWRENCEVILLE, GA 30043-3154
(770) 237-2865
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
10/26/2011
Last updated
10/26/2011
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