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Individual

RAVEN NEWBERRY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
227 WINGFIELD WAY, KATHLEEN, GA 31047-2847
(229) 942-0618
Mailing address
201 2ND ST STE 1100, MACON, GA 31201-6328

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary

Other

Enumeration date
02/13/2015
Last updated
02/13/2015
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