Individual
VARRENZA LASHAUN BAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CTRS
Contact information
Practice address
1701 HARDEE AVE SW, ATLANTA, GA 30310-5110
(404) 321-6111
Mailing address
174 SHOAL PARK DR, MCDONOUGH, GA 30252-5822
(256) 390-6779
Taxonomy
Speciality
Code
Description
License number
State
225800000X
Recreation Therapist
Primary
82164
GA
Other
Enumeration date
08/25/2020
Last updated
08/25/2020
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