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1891230579
KAWANZA ROACH
DALLAS, GA
NPI
1891230579
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2017-01-04
Last Update Date
2017-01-04
Business Address
-- KAWANZA ROACH
233 SILVER SPRING ST
DALLAS, GA 30157-8289
Phone number: 678-670-9639
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Mailing Address
-- KAWANZA ROACH
233 SILVER SPRING ST
DALLAS, GA 30157-8289
Phone number:
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