Individual
YOLANDA LOCKETTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
208 GLADE LN, ALBANY, GA 31721-4011
(229) 343-3116
Mailing address
208 GLADE LN, ALBANY, GA 31721-4011
(229) 343-3116
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
AB15-000740
GA
Other
Enumeration date
09/26/2016
Last updated
09/26/2016
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