Individual
MARANDA BROUGHTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3146 PANTHER TRL SW, ATLANTA, GA 30311-5426
(404) 621-7166
Mailing address
3146 PANTHER TRL SW, ATLANTA, GA 30311-5426
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
—
—
311ZA0620X
Adult Care Home Facility
Primary
—
—
Other
Enumeration date
09/15/2022
Last updated
09/19/2022
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