Individual
FOLASHADE I. RACHAEL MORAK-GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4440 HIDDEN STREAM DR, LOGANVILLE, GA 30052-2571
(862) 588-0437
Mailing address
4440 HIDDEN STREAM DR, LOGANVILLE, GA 30052-2571
(862) 588-0437
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
07/13/2021
Last updated
07/13/2021
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