Yarquita Waller Bryant
Contractor in Decatur, GA. Individual provider (NPI-1).
NPI number1194503516
StatusActive
Last updated in NPPESSep 18, 2023
Details
- NPI
- 1194503516
- Entity type
- Individual (NPI-1)
- Name
- Yarquita Waller Bryant
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Sep 18, 2023
- Certification date
- Sep 18, 2023
- Last updated
- Sep 18, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 171W00000X | Contractor | – | GA | Yes |
Practice location
1290 Hopkins DrDecatur, GA 30033-3251
Phone 478-919-8353
Mailing address
1290 Hopkins DrDecatur, GA 30033-3251
Phone 478-919-8353
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