Provider Information for 1114395340
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CHERRONICA ORMOND LPC
Sex: Female
NPI: 1114395340
Last Updated: 2023-03-28
Certification Date: 2023-03-28
Certification Date: 2023-03-28
Details
| Name | Value | ||||||||||||
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| NPI | 1114395340 | ||||||||||||
| Enumeration Date | 2015-09-03 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | YES | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 414 WILDWOOD GLN VILLA RICA, GA 30180-2422 United States Phone: | Fax: | ||||||||||||
| Primary Practice Address | 300 COLONIAL CENTER PKWY STE 100N ROSWELL, GA 30076-4892 United States Phone: 954-603-7885 | Fax: | ||||||||||||
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