MAXINE FOMUNUNG

DACULA, GA
NPI1225802168
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy363LP0808X Nurse Practitioner, Psych/Mental Health
(Licence: GA  RN291792)
Enumeration Date2023-11-10
Last Update Date2024-12-04
Business Address
MAXINE FOMUNUNG
3206 THIMBLEBERRY TRL
DACULA, GA 30019-7299
Phone number: 470-461-3426
Mailing Address
MAXINE FOMUNUNG
3206 THIMBLEBERRY TRL
DACULA, GA 30019-7299
Phone number: 470-461-3426