Individual
MALISSA ABENA BAKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4982 VILLAGER LN, STONE MOUNTAIN, GA 30083-3698
(404) 259-1896
Mailing address
4982 VILLAGER LN, STONE MOUNTAIN, GA 30083-3698
(404) 259-1896
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Enumeration date
04/08/2020
Last updated
04/08/2020
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