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1861015844
MODUPE BANJOH
LAWRENCEVILLE, GA
NPI
1861015844
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
163WP0807X Registered Nurse, Psych/Mental Health, Child & Adolescent
(Licence: GA RN285748)
Enumeration Date
2020-05-25
Last Update Date
2020-05-25
Business Address
MODUPE BANJOH RN
175 GWINNETT DR
LAWRENCEVILLE, GA 30046-8444
Phone number: 678-209-2394
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Mailing Address
MODUPE BANJOH RN
3165 MANOR CT
SNELLVILLE, GA 30078-2953
Phone number:
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