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Individual

MS. LARITA PATRICE DALTON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
5641 SAPPHIRE CIR, ELLENWOOD, GA 30294-3584
(912) 492-6828
Mailing address
5641 SAPPHIRE CIR, ELLENWOOD, GA 30294-3584
(912) 492-6828

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary

Other

Enumeration date
06/16/2021
Last updated
06/16/2021
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