Individual
JOANNA NUKOABIA MTUANWI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2082 CHANNING DR, CONYERS, GA 30094-4164
(678) 668-3152
Mailing address
2082 CHANNING DR, CONYERS, GA 30094-4164
(678) 668-3152
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
PHCP010397
GA
3747P1801X
Personal Care Attendant
Primary
PHCP010397
GA
Other
Enumeration date
01/23/2020
Last updated
01/23/2020
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